In the era of modern antibiotics, scarlet fever has become an apparently mild disease. One cannot estimate how many sore throats, caused by the β-hemolytic streptococcus organisms which produce erythrogenic toxin, are aborted by the early use of antibiotics, nor how many atypical skin rashes following fevers are due to scarlet fever. Measurements of antistreptolysin titers and the Dick skin test are seldom carried out in these situations. Furthermore, the streptococcus fortunately remains highly sensitive to antibiotics. Nevertheless, in the first six months of 1969, 697 cases of scarlet fever were reported in New York city. In the equivalent period in 1968, the New York City Department of Health reported 623 cases (written communication, 1970). In addition, it must be emphasized that scarlet fever is a bloodstream invasion of virulent hemolytic streptococcus or its toxins, and all complications of such an invasion remain possible.
One of the rare complications of
Dickinson SJ, Corley G, Santulli TV. Acute Cholecystitis as a Sequel of Scarlet Fever. Am J Dis Child. 1971;121(4):331-333. doi:10.1001/archpedi.1971.02100150105014