Scarlet fever in the baby


Scarlet fever is a very contagious infectious disease that affects babies and young children in particular. The triggering bacteria, so-called streptococci, are transmitted via the smallest droplets of saliva and can lead to symptoms such as fever, sore throat, difficulty swallowing, a specific skin rash as well as headache and body aches. If the disease is diagnosed, antibiotic therapy must be initiated quickly in order to avoid possible secondary diseases or long-term damage such as rheumatic fever or acute kidney inflammation.

General information can be found at: Scarlet fever, scarlet fever rash


Scarlet fever in babies is caused by infection with bacteria of the genus streptococci. These bacteria are found in the saliva of every person and are known as Droplet infection transfer. By sneezing, sniffing, coughing or speaking, the bacteria get into the ambient air and can penetrate the baby's mucous membranes.
In many cases, the infection occurs through a parent or sibling. Babies and children who are in close contact with a sick person are therefore particularly at risk. Especially in community facilities, such as toddler groups or daycare centers, a Scarlet fever disease spread particularly quickly.
The bacteria settle in the Mucous membranes in the mouth and throat and there release certain toxins, so-called toxins, which ultimately lead to the onset of scarlet fever. The baby's own immune system braces itself against the toxin that has already caused scarlet fever in him. If the same toxin is reinfected, the body is immune and the typical symptoms of scarlet fever do not break out. However, there are different strains of strep, each producing different toxins. Another strain of streptococci with a toxin that is still unknown to the body can cause a new infection.


In most cases, the first symptoms of scarlet fever appear after one Incubation time of approximately 5 days on. The sick babies fail Fatigue, poor drinking and high temperatures on. In the first few days, the babies sometimes feel unwell, stomach pain and vomiting.
The sick have severe sore throat and cannot swallow properly. This is because both the tonsils and the palate are severely swollen and one reddish inflamed mouth and throatH becomes visible. On the pharyngeal tonsils arise in the course small whitish specksthat may still be missing in the initial phase of the disease. There is also one Inflammation of the neck and jaw lymph nodeswhich is accompanied by swelling and painful increase in size.
Changes in the skin also occur. Starting from the groin region and the armpit area of ​​the baby, it spreads fine-spotted rash all over the body out. It is noticeable that the Skin area around the mouth is not affected and appears distinctly pale. This phenomenon typical of scarlet fever is also known as perioral paleness. After two to three days, the color changes Tongue of sick babies raspberry red and the taste buds that are on the surface of the tongue swell and form prominent protrusions.
Many sufferers also suffer from a purulent runny nose or an inflammation of the middle ear, as the pathogens also accumulate in the back of the nasal passages and can thus lead to ascending infections.

Itching in scarlet fever

In addition to scarlet fever, there are a few other infectious diseases that babies and children can get sick with. In the case of infections with measles or rubella, skin rashes also develop that spread over different parts of the body and have a very special appearance. In most cases, these rashes are perceived as particularly unpleasant because they are accompanied by a strong, excruciating, unpleasant itching. The babies suffer from the itching severely, are very tearful and difficult to calm down, and begin to rub or scratch the affected areas of skin for relief.

Learn more about the in general Rash in children

The typical rash associated with scarlet fever does not usually begin to itch. This makes the healing process much easier, as the babies are generally calmer and more satisfied.

Scarlet fever rash

The typical rash that occurs with scarlet fever usually begins on the second day of the illness. As a rule, it begins in the skin areas of the groin and armpit region and spreads over the entire body from there, ascending towards the neck. Typically, the area of ​​skin around the baby's mouth is spared. The skin appears pale and flat here. This phenomenon is also known as perioral pallor.
The rash on the rest of the body appears pale red at the beginning and pin-head-sized, closely spaced spots develop, which in most cases are easily distinguishable from one another and do not merge. After a day or two, they turn scarlet red and in some areas flow together into a diffuse rash. The spots are slightly raised and have a rough character. In contrast to other rashes caused by infectious diseases in babies or children, such as measles or rubella, babies do not suffer from excruciating itching when the rash is caused by scarlet fever. After about 4-6 days, the rash will slowly fade again. During the healing phase, flaking of the palms of the hands and soles of the feet of the babies occurs in most cases. This flaking affects only the superficial layers of the skin.

Read more on the subject at: Scarlet fever rash, Rash on baby

Fever in scarlet fever

Since scarlet fever is an infectious disease, it arises in most cases high fever. The first symptoms that become apparent in the sick babies are usually expressions of fever. The babies appear very sleepy, exhausted, very tearful and show a clear drinking weakness. The increased body temperature poses a Defense mechanism of the body's immune system to fight the invading pathogens. At elevated temperatures, the multiplication of the pathogens is restricted and further spread is prevented. The sick children can therefore experience high temperatures up to 39 ° C that often come with Fever attacks and chills accompanied.

Discolored tongue with scarlet fever

In the context of scarlet fever in babies, there are some symptoms that are characteristic of the presence of the disease. The tongue looks rather pale at the beginning of the disease and is covered by a whitish coating.
After two to three days, the coating comes off, the tongue swells and appears a shiny raspberry-red color. In addition, there is a swelling of the taste buds, which are distributed over the tongue. They look like tiny specks protruding from the surface of the tongue.

Further information on the topic can be found here: The scarlet tongue


Do the sick babies already have that at the time of the presentation to the doctor characteristic rash, the diagnosis can usually be made at first glance. If only the babies general signs of infection, such as fever or fatigue, the diagnosis is much more difficult.
A detailed one is important physical examination perform. The doctor should definitely inspect the mouth, throat and ears. Particular attention should be paid to enlarged cervical lymph nodes, (see also: Lymph node swelling in the neck) such as reddened tonsils with a whitish coating or one reddened tongue be laid with swollen taste buds.
As part of a Blood test usually show increased levels of white blood cells or the rate of sedimentation. There are also specific antibodies in the blood that increase with scarlet fever infection.
In addition, the doctor can do the so-called Rumple-Leed test carry out. This involves inflating a blood pressure cuff on the baby's arm or leg for about 5 minutes. In the case of scarlet fever, small purple hemorrhages can then develop in the skin.

Rapid test

To diagnose scarlet fever, a Antigen - rapid test be used. This is done with a cotton swab Smear of the pharynx taken from the baby. After a few minutes, the doctor can use the test to see whether the patient's throat is colonized with streptococci.
It is important to remember that this test does not recognize or indicate all scarlet fever diseases. If the test is positive, there is a streptococcal infection and should be treated with an antibotic as soon as possible. If the test is negative, the test should send another throat swab to the laboratory. Any bacteria that may be present can be grown here and reliably detected.


Proper therapy for scarlet fever in babies consists of initiating one antibiotic therapy. The first choice antibiotic is penicillin and is usually administered intravenously to babies in the form of juice or if they are hospitalized.
The main aim of giving the antibiotic is to ensure that the sick babies no longer pose a risk of infection as quickly as possible. After antibiotic therapy carried out for over 24 hours, there is usually no longer any risk of infection.

Is there a vaccination?

An active one Vaccination against scarlet fever disease there is not any. After an infection, you can get infected again with another strain of streptococci that produces a different toxin and the disease can break out again. After 24 hours of antibiotic treatment, the sick baby is no longer contagious. However, if the disease is cured without antibiotic therapy, there is a high risk of infection until all symptoms have subsided, i.e. up to three weeks.


As with other infectious diseases, scarlet fever can also lead to severe courses and complications.
A toxic course with diarrhea, vomiting, cramps and drowsiness can set in. There is also a risk of blood poisoning, which can lead to meningitis or blood clots forming in the baby's brain. Neurological failures and seizures can also occur. Another secondary disease is rheumatic fever. The immune system forms antibodies against the streptococci, which in turn react with the body's own tissue and can thus lead to joint, heart and kidney damage. The risk of an acute inflammation of the kidneys, known as glomerulonephristis, is also increased. Overall, the risk of long-term effects and secondary diseases can be significantly reduced if the disease is detected early and treated with antibiotics.

Read more on the topic:

  • Blood poisoning in children
  • Meningitis in children


Scarlet fever disease in the baby can up to 3 weeks last. If antibiotic therapy is initiated early, the symptoms will improve significantly after one or two days. After about 4 - 6 days, the rash recedes and a little later the flaking of the skin on the hands and feet begins. Overall, however, it can take up to 14 days before the babies are no longer exhausted and limp. In rare cases, the disease can have a serious course with complications and the occurrence of long-term effects.