Scarlet Fever
Etiology/Diagnosis
- Group A Beta-Hemolytic Strep (Strep Pyogenes) (see Strep Pyogenes)
- Epidemiolgoy
- Most common etiology
- Usually associated with pharyngitis
- Physiology
- Diagnosis
- Elevated anti-streptolysin-O (ASO)
- Elevated DNase B
- Staph Aureus (see Staph Aureus): elaborates erythrotoxin
- Epidemiology
- Physiology
- Release of Pyogenic Exotoxin
- Diagnosis
- Normal anti-streptolysin-O (ASO)
- Normal DNase B
Clinical
- Blanching Erytematous Rash (see Exanthems)
- Diffuse Erythema (blanching): begins on neck and upper trunk
- Red Follicular Puncta
- Linear Antecubital Fossa Petechiae
- Desquamation of involved skin/palms/soles: occurs 5-20 days after onset of eruption
- Pharyngitis
- “White Strawberry Tongue” (seen early): white coating with red papillae
- “Red Strawberry Tongue” (seen later): red tongue with red papillae
- Palatal Petechiae
- Facial Flush with Circumoral Pallor
References
- Enterotoxin B Is the Predominant Toxin Involved in Staphylococcal Scarlet Fever in Taiwan. Clinical Infectious Diseases 2004;38:1498–502