Scarlatina - what is it?
My 5-year-old daughter is very ill with strep throat and scarlatina. What exactly is scarlatina?
Scarlatina is an alternative name for scarlet fever, which is a much less serious infection than it used to be in the past. It is a bacterial infection caused by a form of streptococcus that is spread by droplet infection such as happens with other forms of upper respiratory tract infection. The incubation period is quite short. The particular streptococcus (group A beta haemolytic streptococcus) has declined in virulence in recent decades hence the decline in the seriousness of this infection. That is not to say that the child is not very sick during the illness but rather the risk of complications following the infection is extremely low. In the past when the bacterium was more virulent there used to be a high complication rate following this infection. The infection gets its name from the scarlet appearance of the child’s skin. The rash begins on the neck and chest and then spreads all over the body. This is accompanied by fever and the child can be quite unwell. The cheeks are flushed and the area around the mouth is markedly pale. Most children with scarlatina also have a sore throat and on examination will have infected tonsils with associated glandular swelling in the neck. The tongue is usually coated and after several days the coating fades leaving the surface of the tongue looking like the skin of a strawberry. The rash on the body persists for several days and the soreness in the throat declines as the rash begins to fade. At this stage the child’s skin feels rough and several days later the skin may actually start to peel. There is usually no need to treat the skin because these effects are temporary and usually resolve spontaneously. Penicillin is the drug of choice for treating this condition unless the child happens to be allergic to it. In that case antibiotics such as erythromycin are a suitable alternative.