To improve the recognition of scarlet fever with special clinical manifestations.

A rare and severe complications of scarlet fever (pathogen was not isolated) after closed fracture of humerus: exfoliative skin lesions were investigated, and a reference for the clinical diagnosis and treatment of such patients were provided. Although the presentation of scarlet fever could be clinically diagnosed, most common pathogens were group A β-hemolytic streptococcus (GABHS), further detection may be required to distinguish it from other illnesses, such as measles, Kawasaki disease (KD) and Staphylococcal scalded skin syndrome (SSSS).

Through the clinical symptoms, signs, auxiliary examination, the diagnosis of the patient were determined accurately. The patient was treated after isolation and achieved clinical cure.

GABHS could be spread in local area, it is necessary to improve rapid diagnostic ability for GABHS, and active disinfection and isolation measures should be adopted.