Scarlet Fever: Symptoms, Timeline & What to Expect

Scarlet fever (scarlatina) is a streptococcal infection causing a distinctive rash. It primarily affects children 5–15 years old.

Timeline & Symptoms

Phase	Timing	Features
Incubation	1–4 days post‑exposure	Asymptomatic
Prodrome	Day 1–2	Sore throat, fever (101–104°F), headache, nausea, vomiting, abdominal pain
Rash onset	12–48 hrs after fever	Fine, sandpaper‑like red rash; starts chest/abdomen → spreads to extremities; spares palms/soles; Pastia's lines in flexures
Other signs	Concurrent	Strawberry tongue (white coating → red papillae), flushed face with circumoral pallor, cervical lymphadenopathy
Desquamation	Day 7–10	Peeling of fingertips, toes, trunk (lasts weeks)

Diagnosis & Treatment

• Rapid strep test or throat culture confirms Group A Streptococcus pyogenes.
• Penicillin (or amoxicillin) 10 days is first‑line; prevents rheumatic fever, peritonsillar abscess, glomerulonephritis.
• Contagious until 24 hrs on antibiotics.

Complications (Rare with Treatment)

• Rheumatic fever (heart, joints, brain)
• Post‑streptococcal glomerulonephritis
• Otitis media, sinusitis, pneumonia
• Toxic shock syndrome (rare)

Prompt antibiotic treatment shortens illness, prevents complications, and reduces transmission. Complete the full course even if symptoms resolve early.