eMedicine Specialties > Emergency Medicine > Infectious Diseases

Scarlet Fever: Follow-up

Author: Jerry Balentine, DO, Professor of Emergency Medicine, New York College of Osteopathic Medicine; Executive Vice President, Chief Medical Officer, Attending Physician in Department of Emergency Medicine, St. Barnabas Hospital
Coauthor(s): Daniel P Lombardi, DO, Clinical Assistant Professor, New York College of Osteopathic Medicine; Clinical Preceptor, Albert Einstein College of Medicine of Yeshiva University; Attending Physician and Interim Program Director, Department of Emergency Medicine, Saint Barnabas Hospital
Contributor Information and Disclosures

Updated: May 7, 2009

Follow-up

Further Inpatient Care

  • If odynophagia accompanying streptococcal pharyngitis is especially severe, hospitalization may be warranted for intravenous hydration and antibiotics.

Further Outpatient Care

  • To minimize contagion, a minimum of 24 hours of antibiotic therapy is indicated before a child should return to school.

Complications

  • Cervical lymphadenitis
  • Otitis media
  • Peritonsillar abscess
  • Sinusitis
  • Bronchopneumonia
  • Meningitis
  • Brain abscess
  • Intracranial venous sinus thrombosis
  • Septicemia
  • Hepatitis5
  • Vasculitis6
  • Uveitis
  • Rare but lethal early toxin-mediated sequelae include myocarditis and toxic shocklike syndrome. Late complications of group A streptococcal infection include rheumatic fever and poststreptococcal glomerulonephritis. Weeks to months after the illness, transverse grooves (ie, Beau lines) may appear on the nail plates and hair loss (telogen effluvium) may occur.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize and treat streptococcal infection in a timely manner is a pitfall. Treatment should be started as soon as possible to reduce the occurrence of rheumatic fever.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Diana Kessler, DO, to the development and writing of this article.



More on Scarlet Fever

Overview: Scarlet Fever
Differential Diagnoses & Workup: Scarlet Fever
Treatment & Medication: Scarlet Fever
Follow-up: Scarlet Fever
Multimedia: Scarlet Fever
References
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References

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Further Reading

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Contributor Information and Disclosures

Author

Jerry Balentine, DO, Professor of Emergency Medicine, New York College of Osteopathic Medicine; Executive Vice President, Chief Medical Officer, Attending Physician in Department of Emergency Medicine, St. Barnabas Hospital
Jerry Balentine, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American College of Physician Executives, American Osteopathic Association, and New York Academy of Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Daniel P Lombardi, DO, Clinical Assistant Professor, New York College of Osteopathic Medicine; Clinical Preceptor, Albert Einstein College of Medicine of Yeshiva University; Attending Physician and Interim Program Director, Department of Emergency Medicine, Saint Barnabas Hospital
Daniel P Lombardi, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, and American Osteopathic Association
Disclosure: Nothing to disclose.

Medical Editor

Joseph A Salomone, III, MD, Associate Professor, Department of Emergency Medicine, Truman Medical Center, University of Missouri at Kansas City School of Medicine
Joseph A Salomone, III, MD is a member of the following medical societies: American Academy of Emergency Medicine, Society for Academic Emergency Medicine, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Eric L Weiss, MD, DTM&H, Director of Stanford Travel Medicine, Medical Director of Stanford Lifeflight, Assistant Professor, Departments of Emergency Medicine and Infectious Diseases, Stanford University School of Medicine
Eric L Weiss, MD, DTM&H is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, American Medical Association, American Society of Tropical Medicine and Hygiene, Physicians for Social Responsibility, Southeastern Surgical Congress, Southern Association for Oncology, Southern Clinical Neurological Society, and Wilderness Medical Society
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Robert E O'Connor, MD, MPH, Professor and Chair, Department of Emergency Medicine, University of Virginia Health System
Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Heart Association, American Medical Association, Medical Society of Delaware, National Association of EMS Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

 
 
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