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Scarlet Fever
Scarlet fever is a bacterial infection that causes a bright red rash. It looks and feels like sandpaper, and it's sometimes called "sandpaper rash."
The infection, also called scarlatina, spreads easily from person to person. It gets its name from the red, bumpy rash that typically covers the body.
Scarlet fever vs. Strep throat
The same bacteria causes both scarlet fever and strep throat. The culprit is group A streptococcus, also called group A strep. When the bacteria infects your throat, you have strep throat. You get scarlet fever when a strep A infection in your throat or elsewhere in your body releases toxins into your blood that cause the rash. The toxins also can affect your tongue.
Scarlet fever in adults
This condition is most common among children between the ages of 5 and 15. But anyone exposed to group A strep bacteria can get it.
On lighter skin tones, the rash starts out looking like a sunburn. On darker skin tones, it may be harder to spot the color change. But your skin will feel rough like sandpaper, and you'll be able to see the raised rash bumps.
If you press on your skin, the rash may turn pale. The rash may itch.
The scarlet fever rash often starts on your neck and chest and then spreads. (Photo Credit: Biophoto Associates/Science Source.)
Other signs that you or your child may have scarlet fever include:
Fever, with or without chills
Sore, red throat that may have white blotches
Swollen glands in the neck
Headache or body aches
Nausea, vomiting, and abdominal pain
Red, swollen tongue that may be bumpy or have a whitish coating (strawberry tongue)
Flushed face with a pale ring around the mouth
Deep red coloring in the creases of the arms, legs, neck, and groin
Trouble swallowing
Small, red bumps on the roof of your mouth (petechiae)
Loss of appetite
After the rash goes away, your skin may peel for several weeks.
If you or your child has strep throat, there's a chance it will progress to scarlet fever.
Scarlet fever also can be linked to burns or wounds that become infected -- your own or those of another person.
Is scarlet fever contagious?
Yes, scarlet fever is contagious. The infection is often passed between classmates at school or family members who are in close contact with each other. It's most often spread by contact with the droplets emitted when an infected person coughs or sneezes. It can even be spread if you touch something — like a plate or glass — on which these droplets have landed.
Usually, you'll get symptoms 2 to 5 days after infection. But your symptoms might start as soon as 1 day after infection, or it could take a week for them to show up.
Call your doctor if you or your child has a sore throat, especially if a rash or a fever also is present. Your doctor will run the following tests to check for scarlet fever:
Physical exam. A doctor will take a look at the rash and throat, and see whether lymph nodes are swollen. They'll also look for other symptoms, including:
Throat swab. To confirm whether scarlet fever or strep throat is causing the symptoms, they'll swab the throat and tonsils to test for the group A strep bacteria.
Rapid strep test. A rapid test will give results before you leave the office. If that's negative, the doctor may order a culture, which is a more in-depth test to see if the bacteria is actually present.
It's important to test for strep because other illnesses can cause the same symptoms. They may have different treatments.
Typically, the treatment for scarlet fever is the same as for strep throat. Antibiotics will clear up scarlet fever by killing the strep bacteria that cause it. It may take a couple of weeks to get back to normal. Be sure to let day care providers and classmates know that they may have been exposed. In the meantime, these are some things you can do to make yourself or your child more comfortable:
You should see a doctor right away if you or your child has any of these symptoms:
If your child is less than 2 months old, these are additional symptoms that signal an emergency:
Complications of scarlet fever are uncommon. They happen when the group A strep bacteria moves into other parts of your body. Among them are:
Scarlet fever vs. Rheumatic fever
Rheumatic fever is a rare complication of scarlet fever. If scarlet fever or step throat isn't treated, your immune system can overreact. That causes inflammation in your tissues, including joints and organs. It can affect your heart.
Rheumatic fever happens more often in areas that lack access to antibiotics and prompt medical care.
Scarlet fever is caused by bacteria — group A streptococcus, also called group A strep. The same type of bacteria causes strep throat. One of the obvious symptoms is a rough rash that usually starts on the neck and chest and then spreads. Your tongue also might develop white spots or be red and swollen. Other symptoms of infection include fever, chills, sore throat, and body aches. A throat swab or rapid strep test in the doctor's office can confirm the diagnosis. Antibiotics will clear up the infection. Over-the-counter pain relievers may make you more comfortable. Complications of scarlet fever are rare.
Is scarlet fever dangerous?
If it's not treated with antibiotics, the bacteria that causes scarlet fever can infect your bones, tissue around your spinal cord and brain, and your bloodstream.
Why was scarlet fever so deadly?
Scarlet fever is contagious, so outbreaks in the past used to affect many people. As experts learned more about how the disease spread, they began isolating people who had it. That helped prevent epidemics. Once antibiotics became available in the 1940s, doctors finally had an effective way to combat the infection.
How do you get scarlet fever?
The bacteria that causes the disease can spread through droplets that go into the air when a person coughs or sneezes. You also can get it from touching a surface where droplets have landed.
What is the drug of choice for scarlet fever?
The antibiotics doctors prescribe most for scarlet fever are penicillin and amoxicillin. If you have a penicillin allergy, among the antibiotics you might take instead are:
Is scarlet fever a lifelong illness?
No. Antibiotics will wipe out the infection, and then the rash and other symptoms will begin to clear up. However, having scarlet fever once doesn't give you any kind of immunity. You can get it again.
Can Dehydration Cause Fever? What To Know About Dehydration And Symptoms To Watch For
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5 Reasons Why You Have A Sore Throat But No Fever
Sore throats are incredibly common, accounting for about 4% of visits to family practitioners.
The majority of sore throats are caused by viruses, which can raise your body temperature slightly, but usually not enough to cause a fever (100.4 °F or more).
Sore throat without fever can also be caused by allergies, reflux, STIs, behaviors like yelling or singing, and environmental irritants.
In most cases a sore throat with no fever is nothing to be worried about. "Generally a sore throat without fever is less of a concern than a sore throat with fever," says Hiten Patel, MD, a family medicine physician at The Ohio State University Wexner Medical Center.
Here are five common causes of a sore throat that don't typically cause fever.
1. Common coldOne of the most common causes of sore throat without fever is the common cold. If you have a cold, you might experience other symptoms including:
How to feel better: Common colds will resolve on their own in 7-10 days. Resting, drinking hot tea with honey, or taking ibuprofen for pain can help control symptoms, Patel says.
2. TonsillitisTonsillitis is the swelling of the tonsils, which are those lumps of tissue at the back of the throat. The inflammation, or swelling, is most commonly caused by a viral infection, but it can also be due to a bacterial infection.
Tonsillitis is most common in children under 2, although it can happen in adults as well. If you or your child have tonsillitis, you might notice these symptoms:
Fever with tonsillitis is possible, but unlikely, Patel says.
How to feel better: Viral tonsillitis resolves on its own within 3-5 days, says Patel. Use ibuprofen to control pain and eat soothing foods like popsicles or warm tea. If you or your child have difficulty swallowing or have repeated episodes of tonsillitis, see a doctor. If you have frequent episodes of severe tonsillitis that don't respond to treatment, a doctor may recommend a tonsillectomy, or the removal of your tonsils — though this procedure is done less often today compared to years prior.
Quick Tip: Other viral or bacterial illnesses including strep throat, influenza, COVID, mononucleosis, and hand, foot and mouth disease can also cause sore throats, but if you have any of those illnesses you'll likely have a fever as well, Patel says.
3. AllergiesSeasonal allergies, also known as allergic rhinitis or hay fever, can cause a sore throat with no fever. This happens because of postnasal drip, or mucus from the nose dropping down the throat and irritating it. Allergies can cause a sore throat without fever in kids or adults, says Patel.
If your sore throat is caused by allergies, you'll likely notice that it occurs after you're exposed to triggers like pollen or pet dander.
The other symptoms of allergies include:
How to feel better: The best way to control allergies is by avoiding your triggers where possible, by taking actions like keeping windows closed when allergy counts are high. If you still experience symptoms, use an antihistamine or steroid nasal spray to help control nasal symptoms, which will decrease post-nasal drip to your throat, Patel says.
4. Acid refluxIf you have a persistent sore throat without a fever, it could be caused by acid reflux, says Patel. Reflux, also known as gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD), happens when stomach contents come up through the esophagus into the throat and mouth. When this happens, it can irritate your throat.
Reflux can happen on occasion, or frequently. It's more common in adults, pregnant people, and overweight people, although anyone can experience reflux.
If you have a sore throat caused by reflux, you'll likely notice other symptoms, including:
These symptoms might get worse when you eat certain foods, like acidic or spicy foods, or when you lie down, says Patel.
How to feel better: Lifestyle changes like adjusting your diet and losing weight can help with chronic reflux. For mild or occasional bouts of reflux, antacids can help, but you shouldn't use them every day. If your reflux happens frequently, you should see a doctor, says Jim Keany, MD, co-director of the emergency department at Providence Mission Hospital.
5. STIsCertain STIs can also cause a sore throat, particularly if you've had an oral exposure to the virus.
"To many people's surprise, sexually transmitted diseases such as gonorrhea and herpes can also cause sore throat," says Keany.
A sore throat can also be one of the first symptoms of HIV infection, appearing weeks after exposure. If you have HIV, you may or may not experience a fever.
Oftentimes, STIs have no symptoms. However, you might notice symptoms including:
How to feel better: STIs often require treatment with antibiotics or other antiviral medication. If you suspect your sore throat is linked to an STI, talk with your doctor about testing. Regular STI screenings are part of routine care for all sexually-active people.
When to see a doctorUsually, a sore throat without fever will go away on its own, so Keany recommends waiting a few days before seeking medical care as long as your symptoms are mild.
However, you should seek immediate medical care if you have:
If your symptoms do not improve within a week or if you frequently experience sore throats with no fever, see your doctor, says Patel.
Insider's takeawayOccasionally, sore throat without fever can indicate an underlying health issue, like reflux, allergies, or post nasal drip. Other times, it can be from a more serious infection like an STI that requires medical treatment.
In most cases, a sore throat with no fever is due to an infection or other conditions that will resolve on their own and is not a medical concern, says Patel.
Using ibuprofen to manage pain and sipping warm water with honey can help relieve symptoms until your sore throat goes away, usually within a week.
"This is usually self-resolving and will improve without any treatment," Patel says.
Kelly Burch has been writing about personal finance for more than a decade. She's particularly interested in how finances impact the most intimate parts of a person's life, from educational and reproductive choices to love, immigration, or estate planning. Kelly has written about these topics personally and explored them with experts, including entrepreneurs, multi-millionaires, financial planners, and more.Kelly is a first-generation college graduate and homeowner who integrates her personal experience creating financial stability into her reporting. She's a career journalist, with work appearing in "The Washington Post," "The Chicago Tribune," "Boston Magazine" and more.Kelly lives in rural New Hampshire with her husband, two children, and two dogs. When she's not behind her desk, she can be found getting lost in the mountains and lakes around her home. Follow her on Facebook or Twitter, or learn more here. Read more Read less
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