From the Guidelines
Yes, you can get a rash with strep throat, specifically a condition known as scarlet fever, which is caused by group A Streptococcus bacteria. This rash typically appears as small, red bumps that feel rough like sandpaper and often begins on the neck, chest, and underarms before spreading to other parts of the body. The rash usually develops within 1-2 days after the onset of throat symptoms. Other symptoms of strep throat include severe sore throat, difficulty swallowing, fever, swollen tonsils that may have white patches, and swollen lymph nodes in the neck.
Key Points to Consider
- If you suspect strep throat with a rash, seek medical attention promptly as it requires antibiotic treatment, typically penicillin or amoxicillin for 10 days, or alternatives like azithromycin if you have a penicillin allergy, as recommended by the Infectious Diseases Society of America 1.
- The rash occurs because the strep bacteria release toxins that cause blood vessels in the skin to dilate, leading to the characteristic red appearance.
- Without proper treatment, strep throat can lead to complications like rheumatic fever or kidney inflammation.
- It's also important to note that while strep throat is the most common cause of bacterial pharyngitis, other bacteria can also cause acute pharyngitis, and some may be associated with a rash similar to that seen in scarlet fever, as mentioned in the clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis 1.
Treatment and Management
- The primary treatment for strep throat, including cases with a rash, is antibiotic therapy, which should be initiated promptly to reduce the risk of complications and improve symptoms, as emphasized in the practice guidelines for the diagnosis and management of group A streptococcal pharyngitis 1.
- The choice of antibiotic may depend on factors such as the patient's age, allergy history, and the severity of symptoms, with penicillin and amoxicillin being common first-line treatments, and alternatives like azithromycin available for those with penicillin allergies, as outlined in the treatment regimens for group A streptococcal pharyngitis 1.
From the Research
Strep Throat and Rash
- Strep throat, caused by Group A β-hemolytic streptococcus (GABHS), is a common bacterial infection that can present with various symptoms, including sore throat, fever, and tonsillar exudates 2, 3.
- While the typical symptoms of strep throat do not usually include a rash, there is evidence to suggest that streptococcal infections can be associated with skin manifestations, such as acute urticaria (hives) 4.
- A study published in Pediatrics found that 13 out of 32 cases of acute urticaria were associated with streptococcal pharyngitis, suggesting that beta-hemolytic streptococcal infection may be a causative agent in some cases of urticaria 4.
- However, it is essential to note that the studies on strep throat do not commonly report rash as a symptom, and the primary focus of treatment is on alleviating symptoms and preventing complications, rather than addressing skin manifestations 2, 3, 5.
Diagnostic and Treatment Considerations
- The diagnosis of strep throat typically involves a physical examination, patient history, and diagnostic tests, such as throat culture or rapid antigen detection testing 2, 3.
- Treatment for strep throat usually involves antibiotics, such as penicillin or amoxicillin, which are effective against GABHS and can help alleviate symptoms and prevent complications 2, 3, 5.
- While there is some controversy surrounding the use of antibiotics for strep throat, the current guidelines recommend their use to provide symptom relief, shorten the duration of illness, and prevent complications 3.