Family Nurse Practitioner Exam

A 16-year-old with a severe sore throat and a fine sandpaper rash likely has?

1. Kawasaki's disease

2. Scarlet fever

3. German measles

4. Rubeola

The correct answer is: Scarlet fever

The symptoms described in the question are highly indicative of Scarlet fever, which is caused by Group A Streptococcus bacteria. A key feature of Scarlet fever is the combination of a severe sore throat and a characteristic fine, sandpaper-like rash. This rash typically begins on the neck and chest and can spread to the rest of the body, often accompanied by other symptoms such as fever and a strawberry tongue. Kawasaki's disease is primarily associated with prolonged fever and mucosal inflammation, and while it can involve a rash, it does not typically present with a sore throat as a prominent symptom. German measles and rubeola (measles) present with different rashes and additional systemic symptoms—German measles features a more diffuse rash and often has lymphadenopathy, while rubeola has a distinct progression of rash and includes respiratory symptoms. The specific combination of a severe sore throat along with the described rash confirms that Scarlet fever is the most likely diagnosis.