It is possible to have the disease and not show any of these symptoms. Many young children complain only of a headache and stomachache, without the characteristic sore throat. The tongue becomes bright red, with a flecked, strawberry-like appearance. When a rash develops, this form of strep throat is called scarlet fever . The rash is a reaction to toxins released by the streptococcus bacteria.
Scarlet fever is no more dangerous than strep throat, and is treated the same way.
The rash disappears in about five days. One to three weeks later, patches of skin may peel off, as might occur with a sunburn, especially on the fingers and toes. Untreated strep throat can cause rheumatic fever. This is a serious illness, although it occurs rarely. The most recent outbreak appeared in the United States in the mid-1980s.