From the Guidelines
Strep rash, also known as scarlet fever, should be treated with a full course of antibiotics, typically penicillin V (250-500mg orally four times daily for 10 days) or amoxicillin (500mg three times daily for 10 days), as recommended by the most recent guidelines 1. The choice of antibiotic is crucial in managing strep rash, and it is essential to complete the entire course of treatment even if symptoms improve quickly. For those with penicillin allergies, alternatives include erythromycin (250-500mg four times daily for 10 days) or clindamycin (300mg three times daily for 10 days) 1. It is also important to note that the rash typically appears as a fine, sandpaper-like texture that blanches with pressure, often starting on the neck and chest before spreading to the trunk and limbs. The face may appear flushed with a pale area around the mouth. Symptoms usually resolve within a week with proper treatment, but without antibiotics, serious complications like rheumatic fever or kidney inflammation can develop 1. To manage symptoms, it is recommended to stay hydrated, use acetaminophen or ibuprofen for fever and discomfort, and avoid spreading the infection by washing hands frequently and not sharing personal items. If the rash worsens, fever persists above 101°F despite medication, or if you develop symptoms like joint pain or dark urine after the initial infection, it is essential to contact a healthcare provider 1. In addition to antibiotic treatment, it is crucial to practice good hygiene and avoid close contact with others to prevent the spread of the infection. Overall, the key to managing strep rash is prompt and effective antibiotic treatment, as well as good hygiene practices to prevent complications and transmission. Some key points to consider when treating strep rash include:
- Completing the full course of antibiotic treatment
- Practicing good hygiene to prevent the spread of the infection
- Monitoring for signs of complications, such as rheumatic fever or kidney inflammation
- Seeking medical attention if symptoms worsen or persist despite treatment.
From the Research
Strep Rash Characteristics
- The rash associated with scarlet fever was reported in 89% of cases in a study of children with the condition in London 2.
- The rash typically followed the onset of other symptoms, with a median delay of 1 day 2.
- The pattern of symptom onset varied with age, with sore throat being more common at onset among children aged 5 years and older 2.
Diagnosis and Management
- Scarlet fever may be initially overlooked, especially among older children presenting with sore throat 2.
- Delay in diagnosis beyond the first consultation occurred more frequently among children aged 5+ who presented with sore throat 2.
- National guidance recommends treating people with scarlet fever with antibiotics regardless of severity of illness to speed recovery, reduce the length of time the infection is contagious, and reduce the risk of complications 3.
Clinical Presentation
- The median age of children with scarlet fever in the London study was 4 years, with 48% being female and 70% of white ethnicity 2.
- Sore throat was a common symptom, particularly among older children, and was often attributed to viral infection 2.
- Cases with delayed diagnosis took an average of 1 day longer to return to baseline activities 2.