Scarlet fever and streptococcus

Group A streptococcal bacteria can infect the throat and release substances that trigger the distinctive skin rash of scarlet fever. A person may also have a red, painful tongue, headache, tiredness, and tender [Swollen Glands](/symptoms/swollen-glands/) in the neck. A sore throat is a common presentation of streptococcal infection, but most sore throats are not scarlet fever. A clinician uses the overall pattern, examination, and testing when needed to distinguish causes.

Arrange medical advice when fever, throat pain, and a rough rash occur together. Until assessed, offer frequent drinks, rest, and foods that are easy to swallow. Handwashing and not sharing cups or cutlery can reduce spread. If a clinician confirms or strongly suspects a bacterial infection, they may prescribe [Antibiotic Treatment](/treatments/medical-management/antibiotic-treatment/); use it exactly as instructed and report concerning reactions. Do not use leftover medicine.

Seek emergency help for breathing difficulty, inability to swallow saliva, blue or grey lips, collapse, or severe confusion. Obtain prompt clinical advice for worsening throat pain, reduced drinking, very little urine, a persistent [Fever](/symptoms/fever/), or a rash that looks bruised or does not fade when pressed. A clinician should also review symptoms in someone with a weakened immune system or a serious long-term condition.

Does the symptom pattern fit streptococcal infection? Is testing recommended? How should the throat and rash be cared for at home? When can close contact resume? What reaction to treatment should be reported?