Scarlet fever is a term used for an infection caused by a Group a Streptococcal bacteria. The early treatment of scarlet fever is strongly essential either to prevent further spreading of infection or to prevent the risk of complications consisting of peritonsillar and retropharyngeal abscess, sepsis, hepatitis, acute rheumatic fever, glomerulonephritis, pneumonia, endocarditis, and meningitis. We present a case of scarlet fever with sepsis, hepatitis, and severe acute malnutrition in a 15 year and 6 months old female adolescent. Since the patient had specific clinical features of scarlet fever with continuous fever, sore throat, and productive cough for 4 days, followed by general red maculopapular rash initially from the head and progressively spreading to the rest of her body. The patient was also diagnosed with sepsis, hepatitis, and severe acute malnutrition. Erythromycin, ursodeoxycholic acid, vitamin C, folic acid, and vitamin b complex were given to the patient. Rapid diagnosis and prompt treatment are important to prevent other potential complications such as sepsis, abscess, and acute rheumatic fever. Early diagnosis of scarlet fever simultaneously with adequate treatment will prevent the complications of the disease and its spreading among other children
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