Most of us are aware that a persistent sore throat and a fever are telltale signs of a strep infection, and that they warrant a trip to the doctor for testing, as well as treatment with antibiotics if necessary.
But many parents aren’t aware that vomiting, when accompanied by a sore throat, can also be an indicator of strep in kids — though it’s generally not one in adults.
“Vomiting is a sign of strep throat, especially in children,” Dr. Jen Trachtenberg, a board-certified pediatrician based in New York City, told HuffPost.
Symptoms of strep
Strep throat is a bacterial infection of Streptococcus pyogenes, also called group A streptococcus.
Confusingly, the signs of strep infection are the same as many other viral infections, which is why doctors might run a test before prescribing antibiotics.
Strep infections are more common in children than adults.
Trachtenberg said that in her practice, she regularly sees the following symptoms of strep:
- fever
- sore throat, which in addition to pain can involve reds dots on the back of the throat, swollen tonsils or white patches on the back of the mouth
- swollen lymph nodes (glands in the neck)
- headache
- stomach pain and vomiting
The Mayo Clinic notes that the throat pain of a strep infection tends to come on quickly, and children may complain of difficulty swallowing.
Because these are all common symptoms of a variety of other viral illnesses, your doctor will run a test if they suspect strep.
Interestingly, Trachtenberg noted that physicians often don’t test children under age 3 for strep, since it’s uncommon for them to get this infection and they’re less likely to have complications from it if they do.
Symptoms in a child this age are more likely the result of a viral infection, but your provider will decide if there is a reason to test your child.
When to see the doctor
If the symptoms are the same as many viral infections, which don’t require treatment with antibiotics, how does a parent know when to bring their child to the doctor?
Most sore throats aren’t strep, and most vomiting isn’t strep — though those two symptoms in combination might be a sign of it.
Other potential presentations of strep that warrant a call or visit to the paediatrician include:
- sore throat and swollen lymph nodes
- sore throat and fever
- sore throat and rash
- sore throat for over 48 hours
- any combination of the symptoms listed above
Dr Janine Zee-Cheng, a board-certified paediatrician in Indiana, told HuffPost that sometimes a child will come in with a headache, a stomachache and a fever and test positive for strep without ever complaining of a sore throat.
Coughing and a runny nose, on the other hand, usually signal a viral infection and not strep.
Zee-Cheng said that after years of working with children, they can often tell just by looking at a child’s face that a strep test is going to turn positive. They described this “strep face” as “pale and droopy.”
As always, if your child has a very high fever or a fever that lasts for five days, it’s a good idea to contact your paediatrician. And if your child is having difficulty breathing, they should be seen by a medical provider right away.
Why it’s important to treat a strep infection
Doctors don’t always agree on when to prescribe antibiotics for an ear infection, but antibiotics are always used to treat strep throat after a positive test.
When left untreated, strep throat can lead to serious complications. These include “rheumatic fever, which can lead to swollen painful joints, a specific rash, and also heart valve damage,” Trachtenberg explained.
There is also the possibility of kidney inflammation or disease, called poststreptococcal glomerulonephritis, Trachtenberg said.
But don’t panic — antibiotics don’t need to be prescribed immediately in order to prevent these complications. Even if your child has been having symptoms for a number of days, their strep infection can be effectively treated, and complications averted, with a round of antibiotics.
Zee-Cheng also noted that a rapid strep test in a doctor’s office can sometimes give a false negative result when done too early in the course of an illness, so they generally recommend that families wait a day or so before bringing their child in.
Vomiting, on its own, doesn’t usually indicate strep, and it might be the result of a virus, food poisoning, motion sickness or something as simple as “too many Cheetos, or a large popcorn when they went to the movies,” Zee-Cheng said. But any suspicious combination of symptoms is worth a call to your doctor.
