Scarlet Fever - Symptoms

Authored by Dr Oliver Starr, 03 May 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Laurence Knott, 03 May 2017

Scarlet fever starts with a very sore throat and a high temperature (fever). It is often initially put down to tonsillitis. Sometimes at roughly the same time as the sore throat comes on, the tongue goes red, with tiny white spots. This makes it look like a strawberry, hence the name: strawberry tongue. This is pretty typical of scarlet fever.

After the sore throat and whitish tongue comes a red rash on the cheeks, chest and tummy. If you run your hands over the rash on the tummy and chest it feels slightly rough, like fine sandpaper. This is the typical rash of scarlet fever.

Scarlet fever on a child

By (own work) via Wikimedia Commons

After a couple of days the tongue, previously only slightly red with white spots, goes very red and a bit bigger than usual. Some people call this a 'beef tongue'.

Scarlet fever on tongue

By Afag Azizova (own work) via Wikimedia Commons

By this stage, the combination of a sore throat, rough-feeling rash and red tongue makes the diagnosis of scarlet fever fairly obvious to doctors. If left untreated, the rash and sore throat will fade over about 10 days, but the skin sometimes peels (like with sunburn). Not all people with streptococcal infections develop the rash, as some people are not sensitive to the poison (toxin). A mild form of scarlet fever may occur; this is often called scarlatina.

Further reading and references

My son who will be 3 in April has been on antibiotics (not penicillin as his allergic). He also has asthma. His diagnosis GP- after noticing the rash 2 days prior is German measles. He however has...

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