Scarlet fever — MCCQE Part 1 MCQ

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ModerateChild With FeverScarlet feverMCCQE Part 1

A 6-year-old has fever, sore throat, strawberry tongue, sandpaper rash and a positive rapid strep test. Which of the following is the most appropriate next step?

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Correct answer: B — Treat group A streptococcal pharyngitis with appropriate antibiotics

Treat group A streptococcal pharyngitis with appropriate antibiotics is the single best answer because the age, timing, examination findings and investigations in the vignette fit Scarlet fever better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CPS group A streptococcal pharyngitis guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CPS group A streptococcal pharyngitis guidance