Scarlet fever

**Definition:** A disease caused by an infection with the gram-positive bacteria Streptococcus pyogenes. This disease is characterised by a sore throat, fever, and a red rash. Transmission is commonly by inhalation of infected respiratory secretions, direct skin contact, or indirect contact.

**Long definition:** Scarlet fever is a disease caused by exotoxins released by Group A beta-haemeolytic streptococci. It is most commonly associated with streptococcal tonsillitis or pharyngitis. The majority of cases occur in childhood. It is characterized by sudden onset of sore throat, headache, high fever, anorexia, nausea and malaise. The rash appears 12–48 hours after the onset of fever as a confluent, rough-textured erythema initially involving the neck, chest and axillae but soon becoming generalized. The rash blanches upon pressure, spares the skin around the mouth (“circumoral pallor”) and has been likened to “sunburn with goose pimples”. In the mouth there are signs not only of streptococcal pharyngotonsillitis but also of glossitis (strawberry tongue). The rash begins to fade three to four days after onset with desquamation (peeling) affecting particularly the hands and feet. Scarlet fever may lead to a variety of complications including acute glomerulonephritis and rheumatic fever.

**Inclusions:** - Scarlatina NOS

**Exclusions:** - Staphylococcal scarlatina - streptococcal sore throat