What are the signs and symptoms of scarlet fever exposure, including Gastrointestinal (G.I.) symptoms?

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Last updated: February 14, 2025View editorial policy

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From the Guidelines

The signs and symptoms of scarlet fever exposure include sudden-onset sore throat, fever, scarlet fever rash, headache, and G.I. symptoms such as nausea, vomiting, and abdominal pain.

Clinical Presentation

The clinical presentation of scarlet fever, caused by Group A streptococcal (GAS) infection, typically includes:

  • Sudden-onset sore throat
  • Pain on swallowing
  • Fever
  • Scarlet fever rash
  • Headache
  • G.I. symptoms:
    • Nausea
    • Vomiting
    • Abdominal pain
  • Tonsillopharyngeal erythema
  • Tonsillopharyngeal exudates
  • Soft palate petechiae (“doughnut” lesions)
  • Beefy, red, swollen uvula
  • Tender, enlarged anterior cervical nodes 1

Differential Diagnosis

It is essential to differentiate scarlet fever from viral infections, which may present with distinct symptoms such as conjunctivitis, coryza, cough, hoarseness, discrete ulcerative stomatitis, and viral exanthem 1.

Epidemiology

Scarlet fever typically affects children between 5 to 15 years of age and is more common during winter or early spring in temperate climates, with a history of exposure to streptococcal pharyngitis being a significant risk factor 1.

From the Research

Signs and Symptoms of Scarlet Fever

The signs and symptoms of scarlet fever exposure include:

  • Sore throat 2, 3, 4, 5
  • Fever 2, 3, 4, 6, 5
  • Sandpaper-like, papular skin rash 2, 3, 4, 5
  • Flushed cheeks 3
  • Enlarged lymph nodes 4
  • Tonsillar exudate 4
  • Absence of cough 4

Gastrointestinal (G.I.) Symptoms

There is no direct evidence of gastrointestinal symptoms associated with scarlet fever in the provided studies. However, it is essential to note that the studies primarily focus on the general symptoms and diagnosis of scarlet fever, rather than specifically addressing gastrointestinal symptoms.

Age-Related Symptoms

The pattern of onset of symptoms may vary with age:

  • Children under 4 years old are more likely to have higher fever (>38°C) 4
  • Sore throat is more common at onset among children 5 years and older 5

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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