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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• Scarlet fever facts
• What is scarlet fever?
• What is the history of scarlet fever?
• What causes scarlet fever?
• What are scarlet fever symptoms and signs?
• How long is scarlet fever contagious?
• How is scarlet fever diagnosed?
• What is the treatment for scarlet fever?
• Can scarlet fever be prevented?
• What is the prognosis for scarlet fever?
• Find a local Doctor in your town
• Scarlet Fever Index

People who have scarlet fever should be considered contagious until they have had at least 24 hours of antibiotic treatment. The full course of antibiotics should be completed to ensure that the infection is fully eradicated.

A physical examination is the first step in diagnosis. The doctor will look inside the mouth, feel around the neck, examine a rash, and check for fever. A throat swab will be done to send for culture or to do a rapid strep test to try to find the bacteria. A definitive test consists of culturing a GAS strain that produces the toxin from the patient, but most clinicians presumptively diagnose the infection based on a positive rapid screen test, patient symptoms, and the skin rash. Other tests such as blood tests may be done, depending on how sick the patient appears.

Treatment consists of fluids, rest, and antibiotics. The antibiotics are the same as those used to treat strep throat. Oral penicillin or amoxicillin (Amoxil, DisperMox, Trimox) is the drug of choice and is taken for 10 days. Oral penicillins are inexpensive, well tolerated, and are known to reduce the risk of complications of strep infections. Injectable penicillins are also effective but are not often used. For people with a penicillin allergy, clarithromycin (Biaxin), clindamycin (Cleocin), or selected cephalosporins may be used for 10 days or a five-day course of azithromycin (Zithromax, Zmax) may be prescribed.

If the infection spreads, intravenous antibiotics are used. This includes cases of sepsis and bone infection. If abscesses form in the mouth area or in lymph nodes (suppuration), surgical drainage and aggressive antibiotic therapy is indicated.