(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy.) Abstract: Fever with rash is a relatively common reason for consultation, and scarlet fever is also a disease that starts with fever with rash and has more typical rash features, such as corn rash and strawberry tongue. The patient in this case presented with symptoms of fever, headache, rash, and pharyngeal congestion, and was diagnosed with scarlet fever, which resolved with antiviral treatment. It is important to note that although scarlet fever has a good prognosis with anti-infective treatment, it can be complicated by pneumonia, nephritis, and myocarditis, which can even be life-threatening and require attention. [Basic information] Female, 18 years old [Disease type] Scarlet fever rash [Hospital] Liaoning Provincial People’s Hospital [Consultation time] May 2018 [Treatment plan] Anti-infection treatment (meloxicillin sodium sulbactam sodium) + improvement of gastrointestinal symptoms (pantoprazole sodium) + nutritional support therapy (conversion sugar, vitamin C, vitamin B6) [Treatment cycle] Hospitalization for 6 days, followed by outpatient visit after half a month [Treatment effect] The condition resolved. Treatment effect] The disease was cured. A high school student, accompanied by his mother, came to the clinic with a rash all over his face and neck, and was depressed due to fever. He complained of fever, headache and rash for 1 day. Yesterday, he had fever after waking up in the morning, and his body temperature reached a maximum of 38.9℃, accompanied by headache. The fever persisted at night and a peripheral skin rash with marked itching was observed. For further diagnosis and treatment, he came to our hospital today. After examination, he had a temperature of 38.9℃, a dense corn-like congested rash on the head, face, neck, trunk and extremities, a markedly congested pharynx, small tonsils, no pus spots, and no positive signs on other investigations. After examination, the patient had a relatively typical scarlet fever-like rash and was initially diagnosed with scarlet fever. In order to clarify the diagnosis, the patient was given routine blood work + CRP. 2 hours later the results returned significantly elevated white blood cells with a neutrophil ratio of 96.60%, positive urine protein, and elevated urine leukocyte count, which basically led to the diagnosis of scarlet fever. Isolation treatment was required, and the patient was admitted to the ward after communication with the family. II. Treatment After admission to the hospital, routine care was provided by the Infection Unit, and the respiratory tract was treated in single-room isolation. Further improvement of cardiac enzymes, liver and kidney function ion, chest X-ray, thyroid function and other tests. The patient’s history was characterized by a young, acute onset with fever, pharyngitis, and rash with a typical corn rash, congestive rash, and elevated routine blood leukocytes, predominantly neutrophils, suggesting bacterial infection. It can be differentiated from measles and rubella. The patient had no history of drug use, which could exclude drug-induced scarlet fever-like rash. The diagnosis of scarlet fever was basically established, and the patient was given a pharyngeal swab for bacterial culture to further clarify the etiologic diagnosis, and also to differentiate it from aureus infection (aureus produces erythrotoxin, which can also cause scarlet fever-like rash). Scarlet fever is a group A beta-hemolytic streptococcal infection, and most group A streptococci are still sensitive to penicillin, so treatment is firstly chosen to apply penicillin intravenously. However, because of the patient’s poor appetite and hypokalemia, pantoprazole sodium was given to suppress gastric acid and improve GI symptoms, and some nutritional support was given for symptomatic treatment, such as intravenous drip of converted sugar, vitamin C, and vitamin B6. Within 2 days after admission, the patient was still febrile, with a maximum temperature of 39.2°C, accompanied by sore throat, and the rash on the extremities was still increasing with the increase in temperature, and ibuprofen was given to reduce fever. Considering that there was still fever for 3 days of treatment, penicillin was not effective and there was drug resistance, so we communicated with the family to switch to meloxicillin sodium sulbactam sodium IV drip. III. Treatment effect Under the combined effect of pantoprazole sodium, conversion sugar, vitamin C, vitamin B6, and the merocillin sodium sulbactam sodium that was switched to the patient, the patient did not have fever again, and the rash was gradually subsiding with the appearance of desquamation, and the appetite was gradually restored. The patient was discharged after healing and was asked to follow up with the outpatient clinic in half a month. The prognosis is generally good. It is mainly spread by airborne droplets and produces homozygous immunity after infection, but there is no protection against different types of streptococcal infections. Therefore, after scarlet fever is cured, it is possible to be reinfected with different types and serotypes of streptococci. Therefore, it is important to pay attention to self-protection and to exercise properly to improve immunity. It is also important to keep the air circulating in your home after cure, and to avoid spicy and irritating foods, maintain a light diet, and visit the hospital regularly for review to assess the effectiveness of treatment and to observe for complications. Infectious diseases include chickenpox, measles, rubella, scarlet fever, smallpox, typhoid fever and typhus, which can be distinguished by the shape of the rash and the time of its appearance. Non-infectious diseases such as rheumatic fever, drug rash, systemic lupus erythematosus, and allergic subseptic sepsis. Scarlet fever is an acute respiratory infection that needs to be treated in isolation. It can occur at any age and is more common in children, and can be combined with pneumonia, myocarditis, nephritis, and even infectious toxic shock, such as abnormalities in thyroid function and urinary protein in this patient. The prognosis is generally better with active and correct treatment, but it should also be reviewed regularly after cure to avoid other adverse complications.