However, the therapy does not work

Reddened face and v. a. Cheeks, around the mouth pale skin.

Incubation period. Usually 1-3 days.

Period of infection. 1 day before onset of illness up to 24 hours after starting antibiotic therapy; without treatment up to 3 weeks.

When to go to the doctor's office

Today if

– Your child develops a high fever and sore throat within a few hours. – it to your child also at the 3. day of antibiotic administration does not get better.

Immediately when

– your child becomes increasingly listless.

Show background information

The disease

Pathogenesis and transmission

Unlike a "normal" rheumatic fever Angina scarlet fever is caused by group A streptococcus bacteria, which usually enter through the nasopharynx.

In contrast to other types of streptococci, these produce toxins that cause the typical skin rash. The pathogens are transmitted from person to person via droplet infection by being thrown into the air when coughing, sneezing or talking. Direct contact with the sick person when shaking hands, kissing, or using the same cutlery or dishes also poses a risk of infecting the healthy person. Infection through contaminated water or food is also possible.


Due to the toxins produced by the streptococcus bacterium, the child suddenly suffers from sore throat, difficulty swallowing, headache, aching limbs, fatigue, chills, vomiting and often a high fever. Later, it shows the typical skin and mucous membrane changes with a fiery red throat, spotted colored oral mucosa, spotted colored tonsils and white coating on the tongue. It is shed after 3-4 days.

Between the 2. and 4. On the first day, the fine-spotted rash initially begins in the groin area and on the inner sides of the thighs and then spreads over the entire body, leaving only the mouth-chin triangle unaffected. The non-itchy rash is very different from the rashes caused by measles or rubella. Temporarily fades under the prere of a wooden spatula. After 1-3 weeks, the skin peels, v. a. Palms. The soles of the feet.

In other children, the disease is milder, z. T. without the typical symptoms.


In general, the disease progresses without complications if treated appropriately. Nevertheless, in addition to the highly purulent tonsillitis, a purulent middle ear infection (otitis media) is also possible, which leads to hearing loss if the underlying disease is not treated. Both tonsillitis and otitis media are successfully treated with antibiotics.

Sinusitis (sinusitis). If the streptococci spread beyond the tonsil region, the sinuses become inflamed. This relatively common complication is usually easily treated with antibiotics.

Rheumatic fever. The streptococci lead to defense reactions in the body – in principle a sensible reaction. However, since streptococci have certain identifying characteristics that are also found on the body's own cells, the defense reactions are occasionally directed against the patient's own body and after 2-4 weeks lead to the now rare rheumatic fever. As a result, there is a threat of heart involvement, which develops gradually (over months to years) to sometimes severe heart valve damage. Kidney inflammation (glomerulonephritis) is also possible as a result of rheumatic fever. If suspected, the doctor examines kidney and heart function once the scarlet fever has subsided. A urine examination reveals any inflammation of the kidneys that may have developed.

Blood poisoning. If the pathogens enter the bloodstream in large numbers, they cause the so-called scarlet fever, which threatens life-threatening blood poisoning (sepsis). It begins with high fever, vomiting, diarrhea, bleeding from the skin and mucous membranes, clouding of consciousness, severe heart damage, and shock. This complication is very rare, but is fatal in 30% of cases. Here are a quick diagnosis. Intensive medical treatment necessary for survival.

Abscess of the palatine tonsils (peritonsillar abscess). An encapsulated pus cavity (abscess) in the tonsil region rarely occurs nowadays. However, if the therapy does not work, the child complains of severe sore throat and has problems opening the mouth, you should consult a doctor. In this case, the child must go to the hospital to receive intravenous antibiotics. It may be necessary to open the abscess surgically.

Pneumonia (pneumonia). Pneumonia rarely occurs as a result of scarlet fever today.

Neuropsychiatric disorders. It is debated whether, for example, Tourette's syndrome is a consequence of streptococcal infection.

Confirmation of diagnosis

Inspection. Often the rash and pharyngitis are so characteristic that the doctor does not perform any additional examinations (sog. Eye diagnosis).

Swab. A swab is taken from the throat in mild or atypical cases and if there is any uncertainty. A subsequent rapid test will show within a few minutes if strep is the cause of the illness.


Scarlet fever must be treated to prevent secondary complications and to reduce the severity of the disease. In the classic course of scarlet fever, antibiotic treatment with penicillin (z. B. Ampicillin) is indicated to kill the bacteria. The treatment always lasts 10 days. Alternatively, the broader-acting cefuroxime or loracarbef for 5 days can be considered. Even if the child feels better after a few days, he or she must take the antibiotic for the entire period in order to prevent the late effects of streptococcus. If there is an allergy to penicillin, other antibiotics will be prescribed. In very mild cases, antibiotic treatment should be weighed up.

Your pharmacy recommends

What you can do as a parent

Bed rest and rest.

As long as the child has fever, bed rest is recommended. After the fever has subsided, the child should take it easy for a few more days.

Eating and drinking.

Basically, sick children should drink a lot when they have a fever. To make it easier for the child to swallow the food, solid food should be avoided. Soup, broth, semolina porridge, pudding, or even drinks are recommended instead.

Cool throat compresses.

A cool throat compress with lemon or curd is recommended for acute sore throats, a "fiery" Feeling in the throat, with acute difficulty swallowing or swollen lymph nodes. For the lemon poultice, cut an unsprayed lemon into slices, wrap them in a cotton cloth and press the slices lightly. Place the wrap around the neck. Fasten it with a cloth. The poultice should be left on for ½ to 1 hour. If the lemon juice irritates the skin, use a curd compress instead. To do this, spread 150-250 g of lean curd on the middle of a kitchen towel, fold the sides of the towel over it, and then place the wrap around the neck with as few wrinkles as possible. Cover with an outer towel. The curd can be applied either room-warm or cooled (then rather thinly spread). Let the curd compress work for 2-3 hours and remove it before the curd is dry. If you do not have curd or lemons on hand, a poultice with cool water will also help. To do this, dip a linen towel folded several times lengthwise into cold (about 18 °C) water, wring it out and place it smoothly around the neck, which should be covered from the lower jaw to the ears. Wrap with a towel. After about 20-30 minutes – but at the latest when the poultice has warmed up – the poultice is removed and replaced by a dry silk or cotton scarf.

Warm compresses.

A warm potato or onion poultice is used to loosen mucus if the sore throat persists for a long time. For the potato poultice, place one or two unpeeled hot jacket potatoes in a kitchen towel folded lengthwise and mash them. Place as warm as possible around the neck (check temperature on the inside of your own forearm beforehand) and wrap with a towel. 2-3 hours (resp. leave the wrap on until it has cooled down) or in quick succession. For the onion poultice, you will need two to three finely chopped onions, which you place on a folded kitchen towel. Fill a pan half full with water and heat, cover with a lid and apply the "onion wrap" warm it on both sides. Again, place around the neck as warm as possible, but check the temperature on the inside of your own forearm beforehand. Leave the wrap on until it has cooled down. For the relief of pain. fever serve ibuprofen or paracetamol . The appropriate dosage depends strictly on the weight of the child. Ask your doctor or pharmacist about this!

Complementary medicine


The classic homeopathic remedy for scarlet fever is Belladonna D4, 5 drops 5 times a day, depending on the child's condition; however, this remedy should never replace antibiotic therapy.


There is currently no vaccination against scarlet fever. Although there were vaccines in the past, their development was not pursued further because the scarlet fever pathogens respond well to antibiotic therapy.

Even if the risk of infection is moderate: Only ca. 20% of children who play with a sick child become infected. Nevertheless, general measures are useful as with other colds and respiratory diseases: regular hand washing and, if possible, no close contact with sick people who are still contagious. This means that scarlet children are kept away from others. Even siblings who are still healthy should not visit communal facilities such as school or kindergarten until the doctor allows it.

Unlike many other childhood diseases, a survived scarlet fever does not mean that the child is immune to the streptococcus bacteria for life. If the child falls ill more than two or three times in a "season" If a child is infected with the virus in a short time or in quick succession, it is suspected that he or she will repeatedly infect a person in his or her environment who is not sick, but who harbors the pathogen in his or her throat. If this carrier can be clearly identified, the doctor will take a throat swab and prescribe penicillin for 5 days.

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