Scarlet fever and ear infection

Scarlet fever is associated with group A streptococcal infection and commonly presents with fever, sore throat, swollen neck glands, and a fine rough rash. An ear infection affects structures behind or around the eardrum and may cause earache, irritability, reduced hearing, or fluid from the ear. A child with scarlet fever may also develop ear symptoms, or the ear discomfort may come from pressure during another upper respiratory infection.

The presence of ear pain does not show that a rash is scarlet fever. A clinician can look at the eardrum and assess the throat and skin together. Read about [Strep Throat](/conditions/strep-throat/) for the related throat infection.

Arrange an assessment if a child has a scarlet-fever-type rash with ear pain, especially when fever persists or hearing seems reduced. Give fluids and use only age-appropriate pain or fever medicine according to the label or a clinician's advice. Do not put cotton buds, oil, or unprescribed drops into the ear. If treatment is prescribed, follow the instructions and ask whether [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/) is intended for the throat infection, the ear infection, or both.

Get urgent help for swelling behind the ear, a stiff neck, severe headache, breathing difficulty, confusion, marked sleepiness, or inability to drink. Seek prompt review if fluid or pus comes from the ear, pain is severe, the child becomes more unwell, or a [Fever](/symptoms/fever/) does not settle. A sore throat with [Swollen Glands](/symptoms/swollen-glands/) also merits clinical advice when a rash is present.

Ask whether the eardrum shows infection, whether the throat or skin needs testing, what pain relief is suitable, and how to monitor hearing and fever at home.