eMedicine Specialties > Emergency Medicine > Pediatric

Pediatrics, Scarlet Fever: Follow-up

Author: Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Coauthor(s): Peter Bloomfield, MD, MPH, Resident Physician, UCLA Medical Center/Olive View-UCLA Medical Center Emergency Medicine Residency Program
Contributor Information and Disclosures

Updated: Aug 12, 2009

Follow-up

Deterrence/Prevention

  • Children with scarlet fever should not return to school or day care until they have completed 24 hours of antibiotic therapy.

Complications

  • Suppurative complications
  • Rheumatic fever
  • Acute renal failure from poststreptococcal glomerulonephritis
  • Hepatitis: A recent case report described a 6-year-old boy with hepatitis as a complication of scarlet fever.3

Prognosis

  • The prognosis is excellent; most patients fully recover.
  • Attacks may recur.

Patient Education

  • Patients must complete the entire course of antibiotics, even if symptoms resolve.
  • Warn patients that they will have generalized exfoliation over the next 2 weeks.
  • Emphasize warning signs for complications of streptococcal infection such as persistent fever, increased throat or sinus pain, and generalized swelling.
  • For excellent patient education resources, visit eMedicine's Children's Health Center and Ear, Nose, and Throat Center. Also, see eMedicine's patient education articles Strep Throat and Skin Rashes in Children.

Miscellaneous

Medicolegal Pitfalls

  • Missing or not recognizing the diagnosis entirely, diagnosing a viral etiology, and failing to initiate antibiotics are the most common pitfalls.
  • Other pitfalls include failure to obtain a history of penicillin allergy and administration of long-acting penicillin given intramuscularly (IM).
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Kelli N McCartan, MD, to the development and writing of this article.



More on Pediatrics, Scarlet Fever

Overview: Pediatrics, Scarlet Fever
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Treatment & Medication: Pediatrics, Scarlet Fever
Follow-up: Pediatrics, Scarlet Fever
Multimedia: Pediatrics, Scarlet Fever
References
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References

  1. Yang SG, Dong HJ, Li FR, Xie SY, Cao HC, Xia SC. Report and analysis of a scarlet fever outbreak among adults through food-borne transmission in China. J Infect. Nov 2007;55(5):419-24. [Medline].

  2. [Guideline] Finnish Medical Society Duodecim. Sore throat and tonsillitis. EBM Guidelines. Evidence-Based Medicine. Feb 2 2007;Helsinki, Finland: Wiley Interscience. John Wiley & Sons:[Full Text].

  3. Gidaris D, Zafeiriou D, Mavridis P, Gombakis N. Scarlet Fever and hepatitis: a case report. Hippokratia. Jul 2008;12(3):186-7. [Medline].

  4. Chiesa C, Pacifico L, Nanni F, Orefici G. Recurrent attacks of scarlet fever. Arch Pediatr Adolesc Med. Jun 1994;148(6):656-60. [Medline].

  5. Davis H, Karasic R. Pediatric infectious disease. In: Atlas of Pediatric Physical Diagnosis. 3rd ed. 1997:355-7.

  6. Fisher RG, Boyce TG. Rash syndromes. In: Moffet's Pediatric Infectious Diseases: A Problem-Oriented Approach. Lippincott Williams & Wilkins; 2005:374-6.

  7. Gerber MA. Diagnosis and treatment of pharyngitis in children. Pediatr Clin North Am. Jun 2005;52(3):729-47, vi. [Medline].

  8. Gerber MA. Group A streptococcus. In: Nelson Textbook of Pediatrics. Philadelphia, Pa: WB Saunders Co; 2004:870-4.

  9. Hamour A, Bonnington A, Wilkins EG. Severe community acquired pneumonia associated with a desquamating rash due to group A beta-haemolytic streptococcus. J Infect. Jul 1994;29(1):77-81. [Medline].

  10. Kaplan EL, Gerber MA. Group A, group C and group G beta-hemolytic streptococcal infections. In: Textbook of Pediatric Infectious Diseases. Philadelphia: PA: Saunders; 2004:1142-56.

  11. Kleiegman RM, Feigin RD. Streptococcal infections. In: Nelson Textbook of Pediatrics. 14th ed. Philadelphia, Pa: WB Saunders Co; 1992:698-703.

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Further Reading

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Keywords

scarlatina, scarlatinella, scarlatiniform rash, group A streptococcal pharyngitis, strep throat, group A streptococci, group A beta-hemolytic streptococci, group A streptococcal toxin, strep throat, erythrogenic toxins, pharyngitis, petechiae on soft palate, flushed face with perioral pallor, anterior cervical lymphadenopathy, erythematous exanthem, Pastia sign, white strawberry tongue, red strawberry tongue, treatment, diagnosis

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Contributor Information and Disclosures

Author

Pamela L Dyne, MD, Professor of Clinical Medicine/Emergency Medicine, David Geffen School of Medicine at UCLA; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center
Pamela L Dyne, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Peter Bloomfield, MD, MPH, Resident Physician, UCLA Medical Center/Olive View-UCLA Medical Center Emergency Medicine Residency Program
Disclosure: Nothing to disclose.

Medical Editor

Garry Wilkes, MBBS, FACEM, Director of Emergency Medicine, Bunbury Hospital, Western Australia; Medical Director, St John Ambulance, WA Ambulance Service; Adjunct Associate Professor, Edith Cowan University; Clinical Associate Professor, Rural Clinical School, University of Western Australia, Australia.
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Grace M Young, MD, Associate Professor, Department of Pediatrics, University of Maryland Medical Center
Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians
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

Richard G Bachur, MD, Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston
Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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