Medical Definition of Scarlatina

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Scarlatina: Also called scarlet fever, a disease caused by infection with group A streptococcal bacteria that occurs in a small proportion of people with strep throat.

The incubation period between contracting strep and the onset of scarlet fever is short, typically 72 hours but may range from 1 to 7 days. Illness usually begins with a fever and sore throat and may be accompanied by chills, vomiting, abdominal pain and malaise.

The strep bacteria produces a toxin that causes a rash that appears 1 to 2 days after the onset of illness. The rash initially appears on the neck and chest, then spreads over the body. Typically the rash begins as small red macules which gradually become elevated. The redness fades over a few days and the patient is left with a rough "sandpaper" feeling rash. While the rash is still red the patient may develop what are called Pastia's lines, bright red coloration of the creases under the arm and in the groin. The rash usually lasts for 3 days. As the rash fades, desquamation (peeling) may occur around the finger tips, toes, and groin area.

The throat culture should be positive for group A Strep. There is a rapid antigen test (throat swab).

Therapy is designed to treat the infection with antibiotics (usually penicillin) and relieve symptoms with analgesics, rest, and plenty of fluids. Scarlet fever is usually not a serious illness when treated promptly. Improvement typically begins within 24 hours of starting treatment. Very rarely do the bacteria spread to other parts of the body. If it does, the result may be ear infections, sinusitis, glomerulonephritis or rheumatic fever.

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Last Editorial Review: 1/24/2017

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