Patient: About 2 weeks ago my daughter, aged 3, was very ill. She woke at 2am being sick and continued being sick every couple of hours for around 12 hours. She said that her throat hurt which I assumed was from being sick with no food in her stomach and then had a fever of about 102 for about two days, I kept her temperature down with Calpol. She didnt want to eat and it was an effort to get her to drink although she did manage some small amounts of fluid. She had flushed cheeks which I put down to the temp. I then noticed after the fever a fine red rash all over her body, hundreds of tiny little red spots which seemed worse on her elbow creases, under arms, and back of legs, although it was pretty much all over. Her tongue got a white film over it and then she had a strawberry tongue, bright red with like swollen taste buds. I took her to the doctor, immediately thinking scarlet fever. The doctor said that it was a viral infection. She said she had noticed the tongue but the rash wasnt rough enough or the throat inflamed enough for it to be scarlet fever. I noticed last week her skin on her face was really dry and flakey and then yesterday her thumb and fore finger have started to peel really bad on the tips and she is also complaining of a sore, itchy ear at night that has woken her up. I am now really worried that it may have been scarlet fever and was untreated. What would the complications be? I am very concerned. She is now fine in herself. In fact she is the most lively she has ever been, extremely chatty and jumping all over the place. Your input on this would be extremely helpful. Apologies for the long message. Many thanks in advance, Samantha Barnes.
Doctor: I do understand the concern that your child has scarlet fever. Though the presenting symptoms do resemble scarlet fever, it is difficult to make a confirmatory diagnosis without a physical and a throat swab. Usually most cases of scarlet fever have no complications. On rare occasions it may cause ear and throat infection, pneumonia or rheumatic fever. Since your child is feeling better and is active, I do not see any need for you to be concerned. Though if you really want to rule out scarlet fever, you could ask your doctor for a throat swab and culture or a rapid antigen test. I wish your daughter a speedy recovery, take care.