Bacterial and Viral Rashes
Scarlet fever (scarlatina)
Scarlet fever is strep throat with a rash. The throat infection is caused by a streptococcal bacteria. It is most commonly seen in school-aged children in the winter and early spring, but it can occur in individuals of any age and in any season. It is very contagious, and the risk of transmission can be decreased with good hand washing.
The rash is not serious, but serious complications can occur from the underlying strep throat infection. The most worrisome of these is rheumatic fever, a serious disease that can damage the heart valves and cause long-term heart disease.
- The child's symptoms begin with sore throat (which can be mild), fever, headache, abdominal pain, and swollen glands in the neck.
- After 1-2 days of these symptoms, the child develops a rash on the body that is red and has a sandpaper texture. After 7-14 days, the rash sloughs off and peeling is usually present.
- The face may look very flushed, but the skin around the mouth appears normal.
- Streptococcal bacteria can be treated with antibiotics.
- Have your child seen by your doctor immediately if you suspect he or she has strep throat or scarlet fever.
- Your child will require a full course of antibiotics, which should be completed even if your child is feeling better before before he or she completes the course.
- Your child may return to school in 24 hours after starting the antibiotics if the fever has resolved and he or she is feeling better.
Fifth disease, also known as erythema infectiosum or "slapped cheeks" disease, is caused by a virus (parvovirus B19). This disease tends to occur in the winter and spring but can happen year-round.
- The child initially feels ill and tired; then a rash appears. The rash is characterized by bright red cheeks (the symptom inspiring the name slapped cheeks disease). The rash is warm, nontender, and sometimes itchy.
- In 1-2 days a lacy rash spreads throughout the body. The rash appears to fade when the skin is cool, but with a warm bath or with activity, the rash becomes more pronounced. Once the rash appears, the child is no longer contagious.
- Fifth disease is not serious in otherwise healthy children but can pose a serious problem for children with sickle cell anemia, leukemia, or AIDS.
- The disease can also cause problems for pregnant women.
- Because the child is contagious only before the rash appears, children who develop the rash are free to return to day care.