Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Scarlet Fever and Strep Throat Question: My 6 year old daughter developed Scarlet Fever and had to be treated with antibiotics. Her pediatrician told me that Scarlet Fever is an untreated and more advanced form of strep throat. If this is indeed the case, why didn't she demonstrate any symptoms of strep throat which would have enabled me to have her treated immediately? She seemed to be fine one day, extremely sick with full-blown scarlet fever, the next. Answer: Streptococcus (Group A) is a bacteria that has a liking for the tonsils and throat tissue. Hence, the term Strep Throat. At times, it is quite painful causing symptoms such as difficulty swallowing, enlarged neck glands and fever. There may also be other flu-like symptoms such as muscle aches and weakness. For reasons unknown, there are those (usually children) who show little or no symptoms with infection. They are brought to the doctor with a "sore throat" and little or no fever. The throat is swabbed with a Q-tip to test for Strep because it looks suspicious. A rapid test in the office may show positive results for the strep. Treatment can be started right away, usually with Penicillin or other antibiotic if there is an allergy to Penicillin. Complications such as Rheumatic Fever are prevented with treatment. Scarlet Fever is the name given to a skin rash ( along with the others symptoms that develop after the body's immune system has recognized the presence of the Strep bacteria). It doesn't necessarily mean that treatment was delayed because over half the children that have strep throat do not develop the rash. Another reason might be that the specific strain of Strep has certain characteristics that others don't, literally coded to have the body respond in a certain way. There are complex genetic factors that come into play. Rest assured that your daughter has a good immune system! Also see: My 10 year old daughter is incredibly prone to insect bites. Even when no one else is getting bitten, they seem to go for her! Any suggestions? My 12 year old daughter experiences difficulty sleeping due to fear of the dark and being alone. Is this normal? Ask Dr. Betti your questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.