Differential Diagnosis
Cases need to be differentiated from Far East scarlet-like fever, an infectious disease first reported in the 1950s from Russia. Because its similar clinical presentation to scarlet fever it was initially thought to be caused by a Streptococcus. It is now known to be caused by a Gram negative bacillus - Yersinia pseudotuberculosis. Kawasaki's disease is another important differential, especially in it's incomplete form. In some ways Scarlet fever looks like Kawasaki's disease, but without the eye signs or the swollen, red fingers and toes. But sometimes the signs of Kawasaki's disease may manifest over a few days, rather than all at one time. The complications of missed scarlet fever are significant but rare. The complications of missed Kawasaki's include a 1-2% death rate and coronary artery aneurysm.
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