Measles vs Scarlet Fever
Measles and Scarlet Fever are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Measles vs Scarlet Fever at a glance
- Measles: Highly contagious paramyxovirus with prodromal cough/coryza/conjunctivitis and Koplik spots, followed by cephalocaudal maculopapular rash; vaccine-preventable.
- Scarlet Fever: Group A strep pharyngitis with toxin-mediated sandpaper rash, strawberry tongue, and Pastia lines; preventable sequelae include rheumatic fever and post-strep glomerulonephritis.
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Side-by-side comparison
| Feature | Measles | Scarlet Fever |
|---|---|---|
| At a glance | Highly contagious paramyxovirus with prodromal cough/coryza/conjunctivitis and Koplik spots, followed by cephalocaudal maculopapular rash; vaccine-preventable. | Group A strep pharyngitis with toxin-mediated sandpaper rash, strawberry tongue, and Pastia lines; preventable sequelae include rheumatic fever and post-strep glomerulonephritis. |
| Classic presentation | Three Cs + Koplik spots + cephalocaudal rash in an unvaccinated child.; Prodrome (3-5 days): high fever (often 40 °C), cough, coryza, conjunctivitis (the… | Child with strep throat, sandpaper rash with circumoral pallor, and strawberry tongue.; Sudden sore throat, fever (38-40 °C), headache, abdominal pain,… |
| Workup / key labs | Clinical case definition (fever, generalized maculopapular rash ≥3 days, plus cough/coryza/conjunctivitis) confirmed by IgM positive or RT-PCR positive.;… | Compatible clinical syndrome plus positive RADT or throat culture for group A strep.; Rapid antigen detection test (RADT) on throat swab — if negative in… |
| Imaging | Chest x-ray if pneumonia suspected | Not required for routine diagnosis; Echocardiogram if rheumatic fever later develops |
| First-line treatment | Supportive care: antipyretics, hydration, isolation (airborne precautions for 4 days after rash onset); Vitamin A: 200,000 IU PO on days 1 and 2 (50,000 IU if… | Penicillin V 500 mg PO BID-TID for 10 days (adults) or amoxicillin 50 mg/kg/day (children, divided BID or once daily) for 10 days — drug of choice; Benzathine… |
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