June 12, 2025 Author : Fernanda Marcelino (pediatrics) Scarlet fever is a common disease in children and adolescents , especially between 5 and 15 years of age, but it can also affect other age groups. It is caused by the bacterium Streptococcus pyogenes (Group A Streptococcus); It usually occurs after a throat infection or, more rarely, a skin infection; It is contagious and is transmitted through the respiratory tract, through contact with droplets of saliva or nasal secretions from infected people, who may or may not have symptoms; Having scarlet fever once does not confer immunity, i.e. it is possible to have scarlet fever more than once . Symptoms and diagnosis of scarlet fever The incubation period is 2-5 days after infection. The most common symptoms of scarlet fever are: Soreness and redness of the throat , sometimes with white or yellow spots. Skin rash (exanthema): The rash that makes the skin red and rough usually starts on the face and neck, then progresses to the chest, trunk, arms and legs; The skin folds in the groin, armpits, elbows and other joints become a more intense red; When pressed, the red areas of skin turn white; The tongue may become swollen, raspberry-colored and with white spots; The cheeks appear flushed with a paler area around the mouth. Fever. Other symptoms that may occur are: Swollen lymph nodes in the neck; Difficulty swallowing; Nausea and vomiting; Headache, abdominal pain, body aches; Chills and general malaise. If symptoms that may be related to scarlet fever are present, it is necessary to seek medical care. The diagnosis of scarlet fever is based on the patient's history and symptoms presented. Whenever necessary, a throat swab may be performed to confirm the involvement of Streptococcus pyogenes . Treatment of scarlet fever Scarlet fever is treated with antibiotics and other medications and/or support measures as needed. The skin spots usually begin to disappear after a week and it is common for the skin to peel afterwards, especially on the fingers and toes. Although scarlet fever is not currently considered a serious disease, medical care is essential . If not treated correctly, scarlet fever can cause complications in other tissues and organs, for example, the ear, blood, lungs, heart, kidneys, muscles, joints. More rarely, it can cause rheumatic fever. Preventing scarlet fever Prevention of scarlet fever contagion is done with basic hygiene measures: Frequent hand washing with soap and water (or using a suitable disinfectant), for the patient and caregivers. Respiratory etiquette measures , such as using a disposable tissue to cover mouth and nose when sneezing or coughing, or coughing into the arm, to protect against the spread of infected saliva and secretions. When there is someone with scarlet fever in the home, personal objects, dishes or food should not be shared . It is very important that cutlery, glasses and other objects used are thoroughly washed with hot water and appropriate soap after use. Meet the pediatrics clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
