Signs and symptoms
General symptoms
Some symptoms of scarlet fever are common to other infections, too. These may include:
- Fever (101°F or higher) or chills
- Headache or body aches
- Nausea or vomiting
- Sore throat and pain when swallowing
- Stomach pain
Physical signs
Some physical signs are typical of scarlet fever. They show in the following areas:
- Skin
- Tongue, throat, and neck
Skin
Signs of scarlet fever on the skin include:
- A red rash that feels rough like sandpaper
- Brighter red skin in the creases of the underarm, elbow, and groin
- Pale area around the mouth
- Skin peeling as the rash fades
Tongue, throat, and neck
Signs in these areas include:
- Early in illness: Whitish coating on the tongue
- Later in illness: “Strawberry” (red and bumpy) tongue
- Red and swollen tonsils
- Swollen lymph nodes in the front of the neck
- Tiny, red spots on the roof of the mouth, called petechiae
- Very red throat
- White patches or streaks of pus on the tonsils
How symptoms change over time
Rash appears and spreads
One to 2 days after the illness begins, a red rash usually appears. However, the rash can appear before illness or up to 7 days later.
The rash may first appear on the neck, underarm, and groin (the area where the stomach meets the thighs). Over time, the rash spreads over the body. The rash usually begins as small, flat blotches that slowly become fine bumps that feel like sandpaper.
Color of skin can vary
Although the cheeks might look flushed (rosy), there may be a pale area around the mouth. Underarm, elbow, and groin skin creases may become brighter red than the rest of the rash.
Rash fades and skin may peel
The rash from scarlet fever fades in about 7 days. As the rash fades, the skin may peel around the fingertips, toes, and groin area. This peeling can last up to several weeks.
Complications
Complications can occur after having scarlet fever but aren’t common. This can happen if the bacteria spread to other parts of the body.
Complications can include:
- Abscesses (pockets of pus) around the tonsils
- Arthritis (joint inflammation)
- Ear, sinus, and skin infections
- Pneumonia (a lung infection)
- Post-streptococcal glomerulonephritis (a kidney disease)
- Rheumatic fever (a disease affecting the heart, joints, brain, skin)
- Swollen lymph nodes in the neck
Treatment with antibiotics can prevent most of these health problems.
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