Diagnosing and treating scarlet fever

How is a diagnosis made?

Symptoms experienced are most often mild, but any appearance of rash should be assessed by a medical professional, especially if an infection is bacterial, fungal or viral.

At your consultation, your doctor will conduct a short, but detailed interview regarding your reasons for being there. He or she will assess your symptoms and ask a series of questions to gain an understanding of your medical history, and that of your family, as well as the overall nature of your symptoms.

Some questions that can come up include:

• When did you first begin experiencing symptoms?
• What symptoms are you experiencing other than a rash?
• Have you been finding it difficult to swallow?
• Has your throat been a little tender or sore?
• Have you been feeling a little feverish? If yes, have you tried to take your temperature? How high was (or is) your fever and how long did it last?
• Have you experienced any loss of appetite, nausea, vomiting or tummy pain?
• Have you had headaches recently?
• Have you had, been treated for or recently recovered from a strep throat infection?
• Have you been around anyone who has a strep throat infection recently?
• Do you have any other known health conditions or allergies?
• Are you taking any medications or supplements? (prescription and over-the-counter)

Following a short discussion, your doctor will request a physical exam and look at the various parts of your body affected by rash and bumps. Texture and appearance will be physical elements your doctor will want to assess. He or she will also assess the condition of your throat, tongue and tonsils, and also check the lymph nodes in your neck to see if they are enlarged (swollen). Signs your doctor will look out for include white or yellow specs in the throat and mouth, as well as symptoms of fever, body aches and chills.

Your doctor may wish to perform a few tests to confirm an infection, whether it be scarlet fever or strep throat. He or she may request a throat swab (swabbing the back of the throat), throat culture or rapid strep test (results are returned in less than 24 hours) to collect bacterial material (cells) which can be tested for infection. The laboratory will assess the sample for signs of group A streptococcus bacterium. In some instances, a blood test may be requested to determine an infection.

Your doctor will want to be sure of the infection causing you to feel unwell. Although strep throat and scarlet fever are caused by the same bacteria, treatment methods are not entirely the same. Strep throat doesn’t typically involve symptoms of rash. Both, however, will be treated with antibiotics to combat the same bacteria in the body.

Treatment for scarlet fever

A bacterial infection, scarlet fever is typically treated with antibiotics, which kill bacteria and enable the body’s immune system to fight off the infection. Your doctor will prescribe an antibiotic at a specific dosage. It is important to complete the entire course of an antibiotic, even if you begin to feel better while taking it as this helps to prevent an infection recurrence.

Your doctor may recommend over-the-counter medications to help control symptoms of fever and a sore throat. Ibuprofen or aspirin may be recommended. A doctor will never recommend aspirin to a child younger than 18 years of age who is suffering from a viral infection as the risk for the potentially life-threatening condition, Reye’s syndrome is very high.

Once your fever has broken and you have been taking antibiotics for 24 hours, you should be able to return to normal daily life (work or school). Once the infection is under control with the use of antibiotics, you should no longer be contagious. A full course of treatment should clear a scarlet fever infection in at least 4 to 5 days and a fever should reduce within 12 to 24 hours. Antibiotics, however, may be prescribed for 10 days and sometimes includes taking oral penicillin (for those who are not allergic to penicillin).

If you do not begin to feel better within 24 hours of taking your antibiotic, consult your doctor for a check-up to ensure that nothing is wrong and to determine if there is any reason you may not be responding to treatment.

Other home-care tips your doctor may recommend include:

• For throat tenderness and pain: Make a solution of warm, salty water to gargle with. You can also use a cool mist humidifier to help ease discomfort. Soothing drops (in individuals older than 4 years of age), soups, broths and ice pops or lollies can also provide relief. Throat lozenges (for those older than 4 years of age) can also alleviate tenderness and discomfort in the throat. You can try using a cool mist humidifier to open up the airways and provide some relieve to a sore throat and prevent further irritation as well.
• To alleviate dehydration and lack of appetite: Drink plenty of fluids to keep your mouth and throat moist. Soups and broths can also help to give the body nourishment if you are struggling to consume full meals.
• To relieve rash itchiness: Trim your nails to avoid doing yourself any harm if you do happen to scratch. You can also apply calamine lotion to the inflamed areas of skin to help alleviate itching while the rash heals.

Is a follow-up appointment with the doctor necessary?

If treatment is effective and you don’t develop any new symptoms, it’s not likely that your doctor will request that you come back for a follow-up appointment. It rarely happens that an infection spreads to other parts of the body.

If other signs of infection develop, such as an ear infection or a respiratory condition, such as pneumonia, see your doctor as soon as possible. Any new symptoms or concerns should always be checked by your doctor.