Scarlet fever

Question 1

What is the causative organism of scarlet fever?

Answer 1

Streptococcus pyogenes (Group A Streptococcus)

Question 2

What is the characteristic feature of the scarlet fever rash?

Answer 2

A pinpoint, sandpaper-like, blanching red rash starting on the trunk and spreading

Question 3

What is the typical incubation period for scarlet fever?

Answer 3

2–3 days

Question 4

Is scarlet fever a notifiable disease in the UK?

Answer 4

Yes, it must be reported to the local health protection team

Question 5

List 3 early symptoms of scarlet fever.

Answer 5

Sore throat

Fever

Headache (also: nausea, vomiting, fatigue)

Question 6

What are the oral antibiotic first-line and alternatives for scarlet fever?

Answer 6

First-line: Phenoxymethylpenicillin for 10 days

Penicillin allergy:

<6 months: Clarithromycin

6 months–17 years: Azithromycin (5 days) or Clarithromycin (10 days)

Pregnant/postpartum: Erythromycin (10 days)

Question 7

When should a child be excluded from school/nursery with scarlet fever?

Answer 7

Until 24 hours after starting appropriate antibiotics

Question 8

Who is most at risk of invasive Group A Streptococcus (iGAS)? (Name 3 groups)

Answer 8

Aged ≥75

Immunocompromised

Pregnant or postpartum women

Neonates

Skin conditions, diabetes, CVD, malignancy

Question 9

What is a key oral feature of scarlet fever?

Answer 9

Strawberry tongue

Question 10

Name two immune-mediated complications of scarlet fever.

Answer 10

Acute rheumatic fever

Post-streptococcal glomerulonephritis