An infectious illness in which PYREXIA, headache, vomiting and a punctate erythematous rash (see ERYTHEMA) follow STREPTOCOCCUS infection of the throat or a wound. The rash is caused by a toxin produced by the bacteria; it is symmetrical and does not itch. The skin subsequently peels.
The INCUBATION period varies from 2–3 days to a week. Fever is usually short and sharp, with a rapid rise to 40 °C (104 °F), RIGORs, vomiting, headache, sore throat and marked increase in the rate of the pulse. In young children, CONVULSIONS or DELIRIUM may precede the fever. The rash usually appears within 24 hours of the onset of fever and lasts about a week.
The illness is usually mild and treated with PENICILLIN, but there are occasional complications, the most serious of which is glomerulonephritis (see under KIDNEYS, DISEASES OF). Other complications include: infection of the middle ear (otitis media – see under EAR, DISEASES OF); ENDOCARDITIS; and ARTHRITIS.