Scarlet fever

Synonyms in a broader sense

Medical: Scarlatina

Symptoms of Scarlet Salmon

After the scarlet pathogens have been absorbed into the body via droplet infection, it takes about 2-8 days before the disease breaks out in the child (incubation period). Scarlet fever usually begins with a sudden high fever above 38.5°C, at which the child may have chills and headaches and feel very ill. Nausea, vomiting and loss of appetite are also common accompanying symptoms. Furthermore, a child with scarlet fever has a fiery red (scarlet) throat and pain when swallowing (tonsillopharyngitis), as well as a reddened soft palate (enanthema).

The tonsils are swollen, reddened and have white-yellowish pus stains (spots). If the neck region and neck of a child with scarlet fever is palpated, swollen lymph nodes are usually found, which is a sign that the body’s own defense system is highly active. From the 2nd day of the disease on, a red skin rash (rash after fever) typically appears with pinhead-sized, dense, non-intersecting (non-confluent) patches that are slightly raised and therefore feel like sandpaper.

Usually the rash does not itch and spreads from the groin area over the entire torso of the child, ascending towards the neck. After about 4 days (2-6 days) the rash fades and the skin may then become scaly. The palms of the hands and the soles of the feet are particularly affected.

This peeling of the skin occurs in coarser skin platelets (lamellae) and occurs about 1 to 6 weeks after the onset of the disease, but not in every child suffering from scarlet fever. Another characteristic of scarlet fever is that although the child has intensely reddened cheeks, the area around the mouth is pale (perioral paleness, scarlatinosa facies). On the 4th day of the disease, another characteristic of scarlet fever appears: the strawberry or raspberry tongue.

At the beginning of scarlet fever the tongue of the child is still covered with white, but now the red inflamed tongue buds (papillae) emerge and give the tongue its strawberry or raspberry-like appearance. Scarlet fever is one of the well-known childhood diseases. It is characterized by high fever, sore throat, headache and vomiting.

The so-called “scarlatiform exanthema” is also typical for scarlet fever. This is a rash typical of scarlet fever that begins on the face, where it shows its most characteristic features. The rash appears on the face about 48 hours after the onset of the disease.

Typical are reddened cheeks with recess of the area around the mouth, which is called perioral paleness. This rash on the face is also called “Facies scarlatinosa”. The rash shows a fine spotted, pale red appearance.

After one or two days the fine spots merge into larger areas in some places and become scarlet red. When pressure is applied to the affected areas, the rash fades slightly for a few seconds. In the 2nd to 4th week of the disease the skin on the face becomes flaky.

The rash of scarlet fever is usually most pronounced in the groin. It typically starts in the face and spreads over the trunk of the body to the groin and other joint bends. At the beginning, the fine-spotted rash is pale red.

After about two days it assumes a dark red coloration, which is also called scarlet red. The rash is slightly raised above the skin level, which is also called papular. As a simple comparison, the rash can be thought of as a kind of goose bump.

In principle, the rash can spread over the whole body. However, unlike other childhood diseases such as rubella, measles or chickenpox, you can see a strong emphasis on the rash in the groin, armpits and face. Especially when adults are suffering from scarlet fever, it is possible that not all symptoms occur as in children.

Sometimes only reddish spots are visible in the area of the palate and cheek mucosa. In such cases it may be necessary to take a smear to check whether scarlet fever is actually present. In general, scarlet fever is rarely accompanied by a reddening of the palate. As a rule, the reddish spots in the area of the palate become visible after the first rise in fever. They disappear again shortly afterwards.