Sore throat and rash: Strep infection and other causes

Strep throat is a bacterial infection that can cause a sore throat that sometimes occurs alongside a skin rash. However, a variety of other conditions can also lead to a sore throat and a rash together.

In this article, we discuss eight conditions that can cause both a sore throat and a rash.

Strep throat

Man with a sore throat or strep throat holding his throat
Symptoms of strep throat can include sore throat, nausea, and painful swallowing.

Strep throat results from infection with group A streptococcal bacteria. The American Academy of Family Physicians (AAFP) report that this bacteria causes up to 15 percent of sore throats in adults and up to 30 percent in children.

Strep throat typically causes a sore, scratchy throat. Some people may also develop a skin rash.

Other symptoms of strep throat can include:

  • chills
  • fever
  • headache
  • nausea
  • painful swallowing
  • swollen tonsils with white patches or streaks

Cases of strep throat are most common in late winter and early spring.

Treatments include oral antibiotics and over-the-counter (OTC) pain relievers, such as ibuprofen or acetaminophen. Note that children under 16 years of age should avoid aspirin due to the possible risk of developing Reye’s syndrome.

A person can also treat strep throat at home by:

  • getting as much rest as possible
  • staying hydrated
  • gargling with warm, salty water


Scarlet fever

Scarlet fever rash <br>Image credit: Estreya, 2007</br>
Image credit: Estreya, 2007

In some people, especially children, strep throat can progress into scarlet fever. This bacterial infection causes high fever and a bright red rash, resembling sunburn. The rash typically starts on the chest but can spread to other areas of the body.

Other symptoms of scarlet fever can include:

  • red and bumpy tongue that may have a white coating
  • chills
  • difficulty swallowing
  • facial flushing
  • headache
  • nausea
  • red lines in the folds of the skin
  • swollen lymph nodes on the neck
  • vomiting

Scarlet fever is highly contagious. People can transmit the infection to others for around 14 to 21 days after their symptoms first appear. Antibiotics reduce the risk of transmission, with people typically becoming noninfectious within 24 hours of treatment.

Antibiotics also cut the risk of complications, including serious ones that can affect the heart and other organs.

Home remedies, such as OTC pain medications and saltwater gargles, can alleviate symptoms until the antibiotics take effect.

Infectious mononucleosis

Infectious mononucleosis<!--mce:protected %0A--><br>Image credit: Matibot, 2009</br>
Image credit: Matibot, 2009

Also known as mono, glandular fever, and the kissing disease, infectious mononucleosis results from infection with the Epstein-Barr virus (EBV).

Most people will catch EBV at some point in their lives, but only a minority of these individuals will go on to develop mono or other viral symptoms.

Mono passes from one person to another through bodily fluids, such as saliva. Kissing, sharing utensils, coughing, and sneezing are all common means of transmission.

Mono mostly develops in adolescents and young adults. Signs and symptoms of mono include:

  • sore throat
  • rash
  • soft, enlarged spleen
  • fatigue
  • fever
  • headache
  • swollen tonsils and lymph nodes

While the sore throat and rash that accompany mono typically go away after a few weeks, other symptoms can sometimes last for several months. Treatment involves resting, staying hydrated, and using OTC medications for relieving fever and sore throat.


Measles

measles

Measles is a highly contagious viral infection that is also known as rubeola. It can sometimes be fatal in young children.

The National Institutes of Health (NIH) advise that if one person has measles, the illness will infect 90 percent of the people around them unless they have the measles vaccination or have previously had measles.

Measles causes a sore throat and a rash that comprises large, flat blotches of red skin. Sometimes, these blotches appear to overlap.

Other symptoms of measles can include:

As measles results from a viral infection, there is no specific treatment for it. OTC painkillers can relieve fever and sore throat.

The best way to prevent a measles infection is to get the vaccination. Children can receive the vaccination from 12 months of age.

Adult-onset Still’s disease (AOSD)

Adult-onset Still's disease (AOSD) <br>Image credit: DermNet New Zealand</br>
Image credit: DermNet New Zealand

AOSD is a rare disorder that mainly affects people between 16 and 35 years of age. It is a form of inflammatory arthritis that causes a wide variety of symptoms, which may include:

  • salmon pink rash that may come and go
  • sore throat
  • aching and swollen joints
  • fever
  • muscle pain

Doctors prescribe a variety of medications to treat the symptoms in people with AOSD. These can include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • corticosteroids, such as prednisone
  • immunosuppressive drugs, such as methotrexate


Hand, foot, and mouth disease

Hand foot and mouth rash <br>Image credit: Kessalia19. 2014</br>
Image credit: Kessalia19, 2014

Hand, foot, and mouth disease (HFMD) is a mild viral infection that is most common in young children. Symptoms can include:

  • rash on the feet and hands that may cause blistering
  • sore throat
  • fever
  • irritability
  • loss of appetite
  • painful mouth sores

Most people recover from HFMD in 7 to 10 days without medical intervention.

To ease symptoms, doctors may recommend the following home remedies:

  • avoiding foods that are acidic, salty, and spicy
  • drinking cold beverages
  • eating ice chips or other cold foods
  • rinsing the mouth with warm water after meals
  • taking OTC painkillers
  • using mouthwashes to numb pain

Anaphylaxis

anaphylaxis rash <br>Image credit: James Heilman, MD, 2009</br>
Image credit: James Heilman, MD, 2009

Anaphylaxis is a severe and potentially life-threatening allergic reaction. Many substances can cause anaphylaxis, but some common triggers include:

  • foods, such as nuts, milk, and shellfish
  • insect bites and stings
  • medications, such as penicillin and NSAIDs
  • latex

Signs and symptoms of anaphylaxis include:

  • skin rash
  • sudden swelling of the throat that can cause pain or difficulty breathing
  • drop in blood pressure
  • dizziness
  • fainting
  • hives
  • nausea
  • vomiting
  • weak and fast pulse

Anaphylaxis can be fatal and requires immediate medical attention. Call the emergency services immediately if symptoms occur.

Doctors provide people at risk of anaphylaxis with an epinephrine pen, which they should carry at all times and administer at the onset of symptoms.

Someone else can administer this injection if the person is unable to do it themselves. After using the injection, the recipient should go to the nearest emergency room or wait for an ambulance.


West Nile virus

According to the Centers for Disease Control and Prevention (CDC), the West Nile virus is the most common form of mosquito-borne disease in the continental United States.

Approximately one in five people who get infected with this virus experience relatively mild symptoms, such as:

  • skin rash
  • sore throat
  • aches and pains
  • diarrhea
  • fatigue
  • fever
  • headache
  • vomiting

Most people with mild symptoms recover without treatment. OTC pain relievers can reduce discomfort.

However, around one in 150 people with this infection will develop a much more severe illness that can sometimes be fatal. Symptoms of severe illness can include:

  • disorientation
  • high fever
  • neck stiffness
  • seizures
  • severe headache
  • sudden weakness
  • tremors

Anyone with these symptoms should seek immediate medical attention. Serious complications can include:

  • encephalitis, or inflammation of the brain
  • meningitis, or inflammation of the membranes lining the brain and spinal cord

When to see a doctor

Individuals who have a persistent or severe sore throat and rash should see their doctor. They must also seek medical attention if symptoms include:

  • fever of 102°F (38.9°C) or higher
  • fever that persists for longer than a couple of days
  • neck stiffness
  • rash that becomes extremely itchy
  • severe headaches

Call the emergency services or go to the nearest emergency department for symptoms of anaphylaxis or severe infections, which can include:

  • breathing difficulties
  • disorientation or confusion
  • loss of consciousness

Summary

There are several different conditions, including bacterial and viral infections that can cause a sore throat and rash. Some of these conditions are relatively mild and will usually clear up without medical treatment.

A person should see a doctor if symptoms are severe, persistent, or recurring. Seek immediate medical attention for any condition that causes breathing difficulties, confusion, or loss of consciousness.

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