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Scarlet fever

Scarlatina · Spála

What it is

A group A streptococcal throat infection whose toxin causes a sandpaper-like rash.

Symptoms & signs

  • Sore throat
  • fever
  • fine red sandpaper rash starting on the chest
  • strawberry tongue
  • flushed cheeks with a pale ring round the mouth
  • peeling skin of the fingers after a week

🚩 Get help if…

  • call 112 / 911 now Drowsy, floppy or hard to wake, or a rash that does not fade when pressed
  • call 112 / 911 now Drooling, cannot swallow or struggling to breathe
  • see a doctor soon Fever not better after 2 days of antibiotics or a swollen neck
  • see a doctor soon Dark or bloody urine, or swollen painful joints weeks later

Where it strikes

Medical treatment

  • Penicillin V for 10 days (or amoxicillin)
  • azithromycin or clarithromycin if allergic
  • stay home until 24 h of antibiotics
  • watch for rheumatic fever and kidney complications

Natural & lifestyle

  • Fluids, soft cold food
  • salt-water gargles for older children
  • handwashing and not sharing cups

Emerging & experimental

  • Group A strep vaccines in trials
  • rapid point-of-care strep tests

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Honey for the sore throat — eases throat and cough symptoms in trials; does not replace antibiotics mixed evidence
  • Garlic, oregano oil and other 'natural antibiotics' — untested against strep; untreated strep can cause rheumatic fever anecdotal / traditional
  • Colloidal silver — untested; can turn the skin permanently grey (argyria) anecdotal / traditional

ICD codes