Scarlet Fever (Child)

Scarlet fever is an infection with streptococcal bacteria. These are the same bacteria that cause strep throat. Symptoms include throat pain that is worse with swallowing. A rash may develop. The rash usually appears a few days after the sore throat. It looks like tiny raised pink dots with a rough feeling like sandpaper. The child may ache all over and have headache and a fever.

It is very important that the infection be treated as soon as possible to prevent damage to certain organs. Most often, antibiotics are used to treat the infection. After a few days of treatment, the child may begin to feel better. The rash usually clears after 4 to 5 days. The skin may peel (like after a sunburn) in 1 to 2 weeks.

Home care

  • Be sure to give your child the antibiotic medicines as directed until they are gone or the healthcare provider tells you to stop, even if your child is feeling better. This is very important to prevent later problems from strep infection (such as heart or kidney disease).

  • You may use over-the-counter medicine as directed based on your child's age and weight for fever and discomfort. Aspirin should never be used in anyone younger than age 19 who is ill with a fever. It may cause severe disease or death. If your child has chronic liver or kidney disease, or ever had a stomach ulcer or gastrointestinal bleeding, talk with your child's healthcare provider before using these medicines.

  • Fever increases water loss from the body:

    • For infants younger than 1 year: Continue regular feedings (breast or formula). Between feedings give plain oral rehydration solutions available from grocery and drug stores without a prescription. Ask your pharmacist for a recommendation.

    • For children 1 year or older: Give plenty of fluids like water, juice, gelatin, lemonade, or popsicles.

  • It is OK if your child doesn't want to eat solid foods for a few days as long as he or she drinks plenty of fluids.

  • Ask your child's healthcare provider before giving any over-the-counter medicines.

  • Keep your child home from daycare or school until your child has finished at least 24 hours of antibiotics and is feeling better.

  • Give older children throat lozenges if needed to help reduce throat pain. Gargling with warm salt water may also help. (Dissolve 1/2 teaspoon of salt in 1 glass of hot water.)

Follow-up care

Follow up with the child's healthcare provider, or as advised. 

Call 911

Call 911 if any of these occur:

  • Throat pain causing severe drooling, inability to swallow, or inability to open mouth wide

  • Trouble breathing

  • Unusual drowsiness or confusion

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Fever

    • Your child of any age has repeated fevers above 100.4°F (38°C) or fever of 100.4°F (38°C) that lasts for more than 3 days 

  • Fussiness or crying that cannot be soothed

  • Throat pain or headache that is getting worse

  • Neck pain or stiffness

  • Dark purple rash

  • Blood in the urine

  • Joint pain or swelling

  • Decreased urination

  • Decreased level of activity

  • Excessive sleeping

  • Concern for dehydration

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