This scarlet fever isn't making my toys Real.
September 10, 2008 8:45 PM   Subscribe

YANMD: What other illnesses could be mistaken for scarlet fever? Bonus question: If you've had scarlatina, what was it like?

Brief timeline:
  • Sunday P.M. = fatigued
  • Monday A.M. = fatigued + nauseous + achy joints
  • Monday P.M. = all of the above + fever + vomiting + awoke from a nap with a few random itchy red bumps on my waist and leg
  • Tuesday A.M. = fever + more bumps + call to my doctor's office for an appointment
  • Tuesday P.M. = Diagnosis of scarlatina + a prescription for an antibiotic.
Problem(s)? While my throat does appear stripy & raw, it hasn't been sore like strep throat. The doctor (new partner in my GP's office) didn't take any blood tests or swab my throat. She stated that this strep is a different strain and wouldn't show up in the culture. My tongue doesn't have the classic "strawberry" appearance of scarlet fever (although it does have a white film), my skin isn't red in blotches--just pustules appearing here, there, and everywhere, and my lymph nodes aren't swollen.

She did state that scarlatina is a childhood disease and that adults rarely get it. Since I run a community computer lab in the evenings, she thought I might have picked it up from one of the kids that visit.

Now, I'm still running a temperature and even more pustules are appearing. I'm itching like mad and feel worse than before, despite the antibiotic. I took some more Benadryl and will try to sleep without clawing myself apart. If I'm still running a temp in the morning, I will schedule another visit.

Basically, I'm curious if anyone here has had scarlatina and if it was anything like this. What the hell else could it be? My first thought was chicken pox, but I already had a (mild) dose sixteen years ago.

posted by bonobo to Health & Fitness (9 answers total)
Really hard to tell based just on your description, and without seeing the rash, as it could indeed be scarlatina. I think the red tongue mainly happens to kids. Are you really certain you already had chicken pox (if your pustules have fluid in them - very itchy blisters, that sounds like chicken pox).

For what it is worth, here is the wikipedia entry on exanthem, or childhood rash, where they note that historically, five "classical" childhood exanthems have been recognized. They include measles (rubeola), chickenpox (varicella), rubella (German measles), erythema infectiosum (fifth disease), and scarlet fever.

Also, the Mayo clinic site has a good picture of the scarlet fever rash in the symptoms section on scarlet fever - do click to enlarge. They also have a very a good picture of the chicken pox rash in the same symptom section on that disease. The large photo shows the typical fluid-filled chicken pox rash blisters really well.

You have my sympathy, as these childhood illnesses are really miserable to get as an adult. I have never had scarlatina but had chicken pox in high school.
posted by gudrun at 10:46 PM on September 10, 2008

I had strep throat and scarlet fever a couple of years ago, but it was classic in its presentation. I had a VERY sore throat, low-grade fever, achiness, then after about 3-4 days I developed the rash on my chest and neck. My rapid strep test was positive. I did not have the strawberry tongue, but I did have swollen lymph nodes, and a stripey throat. Once I started the antibiotics, I started to feel better within 4-6 hours, and by 24 hours all of my symptoms were tolerable.

The whole experience reinforced for me the magic of appropriate antibiotics. I was completely better within 3 days—this after 5 days feeling like I was swallowing razor blades.

You don't sound like a classic case. I never had pustules that "itched like mad". Maybe you do have something else. Have you looked at the other common childhood rash diseases? Fourth disease or fifth disease (they are real), or chicken pox/shingles, measles, etc. I had chicken pox at twelve and it sounds more like what you are describing.

Sorry I don't know more. Good luck.
posted by rintj at 10:52 PM on September 10, 2008

My two younger brothers both had Scarlet Fever at the same time when they were kids. That was a long time ago, but I remember they both had very, very sore throats, high fevers and the red rash. After the fever and sore throat went away (like rintj, after seeing the doctor, getting diagnosed and getting antibiotics they started getting better pretty quickly), the skin on their fingers and hands started peeling off in strips. I remember that most of all, because it grossed me out and I made them both wear gloves at the dinner table (hey, I was a bossy big sister and they were young enough that they still listened to me).
posted by Oriole Adams at 1:45 AM on September 11, 2008

I had scarlet fever as a teenager and your rash sounds similar to mine. Mine started in warm places, like my underarms and on my chest. The itching was truly unbearable and kept me from sleeping for a couple of days.
posted by jrichards at 6:35 AM on September 11, 2008

I had scarlet fever at seventeen. Unbelievably sore throat, to the point I started spitting out my saliva instead of dealing with the pain of swallowing it. It was like nothing I had ever experienced before, and I had dealt with strep many times. I was covered head to toe in a rash, but it did not itch at all that I remember. The fever was extremely high and couldn't be controlled very well by fever-reducers. I was never nauseous or vomiting, and I didn't have the strawberry tongue for what it's worth.

The good news is that literally within 24 hours of going on an antibiotic, I felt so much better. Within 3 days I was getting out of bed and eating again, and a week later I was back to my old self.
posted by Ugh at 8:34 AM on September 11, 2008

When I was a kid I had Scarlet Fever and I almost died (not to scare you) because they thought it was bronchitis.

I had already been to the doctor, and had been on a two-day regimen of antibiotics; I think I was about 8 years old. I remember suddenly feeling much, much worse: intense throat pain, really high fever/delirium, blurry vision, swollen tongue... I remember crawling out of my bed and crawling into my parents' bedroom crying and saying "mommy, wake up, I'm going to die. I feel it, I'm dying, mommy."

This freaked my parents out severely and they took my temperature, which was 104F.

They drove like bats out of hell as quickly as they could to my pediatrician (which was 45 minutes away!) and by the time I got there, I was going in and out of consciousness.

I remember them telling me I had to have a shot of penicillin immediately because if they didn't get my fever down quickly, it could destroy my retinal nerves (think Mary on Little House on the Prairie).

They told me to pull my pants down and I was like okay, let me see the needle, and the nurse wouldn't, so my mom asked her to just put it behind her back and I FREAKED... I started screaming and trying to climb the walls to get away because I was so delirious and afraid. And then they gave me the shot, and maybe because I was tiny or struggling, but it felt literally like an ice pick going into my ass. I still get a twinge there now and then.

The shot was so strong that I was paralyzed for about 10 days. However, I recovered just fine. I remember lying in my room, unable to move, with a series of Disney records stacked on those old record players where you could put a bunch on at once and they would just drop, play through, then drop and play another one...

So I guess what I'm trying to tell you with this horror story is that IF you continue to feel like shit and you monitor your temperature regularly, and the symptoms get ANY worse... go to the emergency room. You might want to have a friend or SO on standby with a saved text you can send without typing (again, you may be delirious) saying "come get me now, it's emergency room time" and they will give you a shot like they did me.

It's imperative that you NOT run a high temperature for very long, as you can get brain damage, go blind or die. When I say high, anything above 102 is what you should worry about, and if your temp is 102, watch it closely.

I know, I know, I'm not a doctor and I was a kid. But I remember the pediatrician telling my parents if they'd waited another 3 hours to get me the shot, I would have gone blind or had permanent brain damage and you don't want that.

For your throat, I would suggest sucking on something rather than swallowing liquids if you can handle it... swallowing anything that has volume might hurt, even though you say your throat isn't sore now. Bathe in oatmeal (packets from Aveeno are single-bath-sized and smell and feel great) for the itching/rashes.

Best thing about it? I have never gotten strep, EVER. I think once you have something like Scarlatina you develop a resistance to strep... any MD's on the site, feel free to correct me about this, it's anecdotal.
posted by Unicorn on the cob at 12:14 PM on September 11, 2008

I have never gotten strep, EVER. I think once you have something like Scarlatina you develop a resistance to strep... any MD's on the site, feel free to correct me about this, it's anecdotal.

I had a pretty bad case of Scarlatina as a kid and I've had strep throat twice in my adult years so this statement is false.
posted by MaryDellamorte at 3:31 PM on September 11, 2008

Response by poster: Thanks for the feedback, folks.

I'm feeling significantly better today (day four on antibiotics), body temp. is back to its typical 97.5-98° range, the fatigue and soreness have improved, and the early blisters have stopped itching and appear to be going away. I had a couple of days with mild red splotches on my chest, arms, and legs. That and the rough, perpetually goose-bumped appearance have faded.

My SO had been feeling rough for a few days. I saw that his throat was red-striped and asked him to go to our doctor, too. He had a serious problem with a strep illness once, so he went--just in case. They gave him the same strong antibiotic I'm taking. The next day HE had the spots, but they're already much better and didn't get as annoying as mine.

Huzzah to you, Judicious Application of Antibiotics!
posted by bonobo at 3:02 PM on September 13, 2008

Best answer: [Another update for the sake of posterity and in case anyone else should have similar symptoms.]

A week after my prior post, I returned to the doctor's office because the fatigue worsened and more bumps appeared. I saw another partner in the office and he said that I was misdiagnosed--it was viral exanthem instead of bacterial and that a rapid strep culture would have, indeed, indicated Scarlatina had it been positive. He took me off the antibiotics and said I'd have to wait it out and get some rest.

Fast forward to a week-and-a-half ago--outrageous fatigue and joint pain. After a few days, my throat reddened and swelled painfully. Went back to the same fellow I saw last time. Rapid strep was negative. He found tenderness in my spleen/liver area and said that it's a mono virus. I had mono eighteen years ago and am now possibly dealing with Epstein-Barr. Looking at images of the rash that can appear with Epstein-Barr, it appears that I had it as far back as September. The doctor prescribed steroids for the throat swelling and joint pain and antibiotics to fight off any secondary infections that may appear.
posted by bonobo at 9:08 PM on December 4, 2008

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