Red flags & when to go in person for Scarlet Fever (Child) - Triage

Audience: pediatric

Scarlet fever is a childhood illness caused by bacteria that often starts with a sore throat, fever, and a red rash. It usually affects children between 5 and 15 years old. While many children recover well with proper care, some signs mean you should seek medical help in person. This guide helps parents and caregivers recognize these warning signs, understand what telemedicine can and cannot do for scarlet fever, and know when to visit a healthcare provider face-to-face. Early treatment can prevent complications, so watching for red flags like difficulty breathing, dehydration, or worsening symptoms is important. Telemedicine can support initial evaluation and advice but cannot replace physical exams or urgent care when needed. Always prioritize your child's safety and seek immediate care if serious symptoms appear.

Red flags — go in person / ER

• Difficulty breathing, wheezing, or noisy breathing — seek emergency care immediately.
• Severe throat pain or drooling making swallowing difficult — go to urgent care or emergency room.
• High fever unresponsive to medication or signs of dehydration (dry mouth, no tears, little urine) — seek in-person medical attention promptly.

What telemedicine can do

• Initial symptom assessment and advice.
• Reviewing rash and symptom photos.
• Prescribing antibiotics when appropriate.
• Guidance on home care and when to seek further care.

What telemedicine cannot do

• Performing throat swab or rapid strep test.
• Evaluating severe or emergency symptoms.
• Treating breathing difficulties or dehydration.
• Monitoring rapidly worsening conditions requiring physical exam.

What is Scarlet Fever?

Scarlet fever is an infection caused by group A Streptococcus bacteria. It usually starts with a sore throat and fever, followed by a red rash that feels like sandpaper. Other symptoms may include a red, swollen tongue (sometimes called "strawberry tongue"), headache, and swollen glands in the neck. It spreads through coughs, sneezes, or close contact with someone who is infected.

Common Symptoms in Children

Children with scarlet fever often have:

Symptoms usually appear 2 to 4 days after exposure.

Red Flags: When to Seek In-Person Care Immediately

Certain signs mean your child needs urgent medical attention in person:

If any of these occur, go to the nearest emergency room or call emergency services.

How Telemedicine Can Help

Telemedicine can be useful for:

During a tele-visit, a healthcare provider can review symptoms, look at rash pictures, and answer questions. However, some evaluations require physical exams that cannot be done remotely.

Limitations of Telemedicine for Scarlet Fever

Telemedicine cannot:

If your child’s condition worsens or you notice any red flags, seek in-person care immediately.

Preparing for a Telemedicine Visit

Before your tele-visit, prepare by:

This helps the healthcare provider make the best assessment possible.

Aftercare and Monitoring

After the tele-visit:

Prompt treatment usually leads to full recovery without complications.

How to prepare for your tele-visit

• List all symptoms and their start dates.
• Take clear photos of rash and tongue.
• Have a thermometer ready to check temperature.
• Prepare questions or concerns to discuss.
• Find a quiet, well-lit space for the tele-visit.

After your tele-visit

• Follow all prescribed treatments and medication instructions.
• Keep your child hydrated and rested.
• Watch for any worsening symptoms or red flags.
• Avoid contact with others until no longer contagious.
• Schedule follow-up care if symptoms persist or worsen.

FAQs

What causes scarlet fever in children?

Scarlet fever is caused by group A Streptococcus bacteria, the same bacteria that can cause strep throat. It spreads through respiratory droplets when an infected person coughs or sneezes.

Is scarlet fever contagious?

Yes, scarlet fever is contagious. It can spread easily among children through close contact, coughing, or touching contaminated surfaces. Children are usually contagious until they have been on antibiotics for at least 24 hours.

How is scarlet fever treated?

Treatment typically involves antibiotics prescribed by a healthcare provider to kill the bacteria. This helps reduce symptoms, prevent complications, and stop the spread to others. Supportive care includes rest, fluids, and fever reducers.

Can scarlet fever be serious?

Most children recover fully with treatment, but if left untreated, scarlet fever can lead to complications like ear infections, kidney problems, or rheumatic fever. Prompt medical care reduces these risks.

When should I take my child to the hospital?

If your child has trouble breathing, severe throat pain, high fever not responding to medication, signs of dehydration, or a rapidly spreading rash, seek emergency care immediately.

Sources

1. Scarlet Fever — MedlinePlus, U.S. National Library of Medicine.
2. Scarlet Fever Information for Healthcare Providers — Centers for Disease Control and Prevention (CDC).
3. Scarlet Fever — Mayo Clinic.
4. Scarlet Fever — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or red flags, seek immediate medical attention in person.