Can strep throat cause scarlet fever?

Scarlet fever is an illness caused by toxin-producing group A Streptococcus. It may begin with a sore throat, fever, swollen neck glands, or painful swallowing, followed by a fine, rough rash that can feel like sandpaper. The tongue may look red and bumpy, and the skin folds can appear more intensely red. A rash with a sore throat does not prove the cause, so examination and testing may be needed.

Contact a clinician if a child or adult has a sore throat with fever and a new rough rash. Testing can help distinguish streptococcal infection from viral illness. If prescribed an antibiotic, take it exactly as directed and complete the course unless the prescriber changes the plan. Encourage fluids, rest, and handwashing; avoid sharing cups, utensils, or towels while infection is suspected.

Get urgent help for difficulty breathing, drooling, inability to swallow fluids, severe dehydration, unusual drowsiness, or rapidly worsening swelling of the throat or neck. Seek prompt review if fever persists, the rash is spreading quickly, or symptoms are not improving after treatment. A clinician should also assess a child who appears very unwell.

Ask whether a throat swab is needed, whether the rash fits scarlet fever, how long the person should stay away from school or work, and what symptoms would require reassessment.