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Tests and diagnosis
By Mayo Clinic staffYour doctor will conduct an exam to determine the cause of your child's sore throat, rash and other symptoms. He or she will:
- Look at the condition of your child's throat, tonsils and tongue
- Feel your child's neck to determine if lymph nodes are enlarged
- Assess the appearance and texture of the rash
If your doctor suspects strep as the cause of your child's illness, he or she will also swab the back of your child's throat to collect material that may harbor strep bacteria. Tests for the strep bacterium are important because a number of conditions can cause the signs and symptoms of scarlet fever, and these illnesses may require different treatments. If there are no strep bacteria, then some other factor is causing the illness.
Your doctor may order one or more of the following laboratory tests:
- Throat culture. The sample from your child's throat is examined in a laboratory test in which the bacteria can thrive. Although this is a very reliable test, the results may take as long as two days.
- Rapid antigen test. Your doctor may also order a rapid antigen test, sometimes called a rapid strep test, which can detect foreign proteins (antigens) associated with strep bacteria infection. This test can be completed during a visit to your doctor's office. This test is less reliable than is a throat culture. If a rapid antigen test is negative, your doctor will probably order the throat culture to ensure an accurate diagnosis.
- Rapid DNA test. Your doctor may also be able to order a relatively new rapid test that uses DNA technology to detect strep bacteria from a throat swab in a day or less. These tests are at least as accurate as throat cultures, and the results are available sooner.
- Arumugam V, et al. Scarlet fever. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/119790350-5/802768093/1701/530.html#4-u1.0-B978-0-323-04134-8..50022-7--cesec71_11163. Accessed Feb. 10, 2009.
- Exanthems and drug eruptions. In: Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo.: Mosby; 2006. http://www.mdconsult.com/das/book/body/119754552-5/802599473/1195/85.html#4-u1.0-B0-323-01319-8..50016-9--cesec21_1617. Accessed Feb. 10, 2009.
- Gerber MA. Group A streptococcus. In: Kliegman RM, et al. Nelson Textbook of Pediatrics.18th ed. Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/119754552-5/802599473/1608/526.html#4-u1.0-B978-1-4160-2450-7..50184-5--cesec9_4149. Accessed Feb. 10, 2009.
- Streptococcal and enterococcal infections. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec14/ch171/ch171d.html. Accessed Feb. 10, 2009.
- Scarlet fever. American Academy of Family Physicians. http://kidshealth.org/PageManager.jsp?dn=familydoctor&lic=44&article_set=22939. American Academy of Family Physicians. Accessed Feb. 10, 2009.
- Fever in infants and children. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/tools/symptom/504.html. Accessed Feb. 10, 2009.
- Leslie DL, et al. Neuropsychiatric disorders associated with streptococcal infection: A case-control study among privately insured children. Journal of the American Academy of Child and Adolescent Psychiatry. 2008;47:1166.
- Group A streptococcal infections. National Institute of Allergy and Infectious Diseases. http://www3.niaid.nih.gov/topics/streptococcal/default.htm. Accessed Feb. 10, 2009.
- Scarlet fever. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dbmd/diseaseinfo/scarletfever_g.htm. Accessed Feb. 10, 2009.
- PANDAS. Pediatrics & Developmental Neuroscience Branch. http://intramural.nimh.nih.gov/pdn/web.htm. Accessed Feb. 10, 2009.
