RT Book, Section
A1 Shah, Ashish
A1 Sobolewski, Brad
A1 Mittiga, Matthew R.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181044452
T1 Scarlet Fever (Scarlatina)
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181044452
RD 2024/04/23
AB Scarlet  fever  manifests  as  diffuse  blanching  “sandpaper-like”  erythematous  macules  and  papules  caused  by  erythrogenic  toxin  production  from  group  A  β-hemolytic  Streptococcus  pharyngitis.  Occasionally,  the  site  of  infection  is  skin  (impetigo)  or  perianal.  The  disease  usually  occurs  in  children  2  to  10  years  of  age.  The  typical  presentation  of  scarlet  fever  includes  fever,  headache,  sore  throat,  nausea,  vomiting,  and  malaise  followed  by  the  characteristic  scarlatiniform  rash.  The  rash  initially  occurs  on  the  groin  and  trunk,  spreading  to  the  face  (often  with  perioral  sparing)  and  neck,  then  quickly  becomes  generalized.  Desquamation  occurs  after  5  to  7  days.  On  the  tongue,  a  thick,  white  coat  and  swollen  papillae  may  be  seen  (“strawberry  tongue”).  Palatal  petechiae  and  tender  anterior  cervical  lymphadenopathy  may  be  present.  The  gold  standard  for  diagnosis  is  a  positive  throat  culture  of  a  swab  from  the  tonsillar  pillars,  though  rapid  antigen  testing  is  highly  specific  and  can  provide  prompt  diagnosis.  The  differential  diagnosis  includes  enteroviral  infections,  staphylococcal  scalded  skin  syndrome,  viral  hepatitis,  infectious  mononucleosis,  toxic  shock  syndrome,  drug  eruptions,  rubella,  mercury  poisoning,  and  Kawasaki  disease.