Isolates resistant to erythromycin have been found primarily in Japan. However, these are becoming less prevalent with time. Some resistance to treatment may be noted if the patient is simultaneously colonized with H. influenzae that is beta-lactamase producing. Children may return to school after 24 hours of therapy. Indications for tonsillectomy.
Scarlet fever is a self-limited systemic manifestation of streptococcal pharyngitis.
Frequently, there is circumoral pallor. There may occur a fine desquamation that begins on the fingers and toes. The differential diagnosis includes Kawasaki's disease. For recurrent disease , attempt to identify carrier in family with throat and nasal cultures. Treat any identified carriers.