Strep throat, a common bacterial infection, can manifest with a rash. This distinctive rash is a hallmark of scarlet fever, a condition linked to certain strains of Streptococcus pyogenes bacteria. Recognizing this connection and symptoms is important for timely diagnosis and management.
The Rash Associated with Strep Throat
The rash of scarlet fever, or scarlatina, is caused by toxins released by Streptococcus pyogenes bacteria. These streptococcal pyrogenic exotoxins trigger a widespread skin reaction. The rash typically appears 12 to 48 hours after initial strep throat symptoms begin.
The scarlet fever rash is bright red with a sandpaper-like texture. It commonly starts on the neck and chest, then spreads to the trunk, arms, and legs. Skin folds, such as in the armpits, groin, and elbows, may show deeper red coloration known as Pastia’s lines. As the rash fades after about a week, affected skin, especially on the hands and feet, might peel.
Recognizing Other Strep Throat Symptoms
While the rash is a notable symptom, it rarely occurs alone. Strep throat typically presents with a sudden, sore throat, often making swallowing painful. Individuals may experience a fever, often high, with chills. The tonsils might appear red and swollen, and may have white patches or streaks of pus.
Other common indicators include tiny red spots on the roof of the mouth (petechiae) and swollen, tender lymph nodes in the neck. Younger children may also experience headache, body aches, nausea, or vomiting. A unique symptom is “strawberry tongue,” where the tongue develops a white coating that later peels to reveal a red, bumpy surface.
Diagnosis and Medical Care
If strep throat is suspected, with or without a rash, seek medical evaluation. A healthcare provider will perform a physical examination and may conduct tests to confirm Streptococcus pyogenes bacteria. The most common diagnostic tool is a rapid strep test, providing results within minutes by detecting bacterial antigens.
If the rapid test is negative but strep is still suspected, especially in children, a throat culture may be performed for accuracy, though results take 24 to 48 hours. If strep throat is confirmed, antibiotics are prescribed, typically penicillin or amoxicillin. Complete the full 10-day course of antibiotics, even if symptoms improve, to eliminate bacteria and prevent complications.
Potential Complications of Untreated Strep
Ignoring strep throat can lead to serious health complications, as bacteria can spread or trigger immune responses. One complication is rheumatic fever, an inflammatory condition impacting the heart, joints, brain, and skin. In severe cases, rheumatic fever can result in permanent heart valve damage.
Another complication is post-streptococcal glomerulonephritis, a kidney disorder developing one to two weeks after infection. This condition involves inflammation of the kidney’s filtering units, which can impair kidney function. In some children, strep infections have been linked to Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), characterized by sudden onset or worsening of obsessive-compulsive disorder or tic disorders.