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Scarlet fever — RACP Paediatrics MCQ

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EasyInfectious diseases and immunisationScarlet feverRACP Paediatrics

A 5-year-old has fever, sore throat and a fine sandpaper-like rash over the trunk with circumoral pallor. The tongue is red and bumpy and there is tender cervical lymphadenopathy. What is the most likely diagnosis?

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Correct answer: C — Scarlet fever from group A streptococcal infection

Sandpaper rash, strawberry tongue and pharyngitis are typical of scarlet fever due to toxin-producing group A streptococcus. Kawasaki disease causes prolonged fever and mucocutaneous signs but usually lacks exudative pharyngitis and a sandpaper rash pattern. The pearl is that treatment reduces complications and transmission, and local guidance should be followed for antibiotic choice.

Reference: Therapeutic Guidelines (eTG): Antibiotic; RCH Clinical Practice Guidelines