Symptoms:

The time between becoming infected and having symptoms is short, generally 1 - 2 days. The illness typically begins with a fever and sore throat.

The rash usually first appears on the neck and chest, then spreads over the body. It is described as "sandpapery" in feel. The texture of the rash is more important than the appearance in confirming the diagnosis. The rash can last for more than a week. As the rash fades, peeling (desquamation) may occur around the fingertips, toes, and groin area.

Other symptoms include:

• Abdominal pain
• Bright red color in the creases of the underarm and groin (Pastia's lines)
• Chills
• Fever
• General discomfort (malaise)
• Headache
• Muscle aches
• Sore throat
• Swollen, red tongue (strawberry tongue)
• Vomiting

Signs and tests:

• Physical examination
• Throat culture positive for group A strep
• Rapid antigen detection (throat swab)