What are the symptoms of streptococcal infection in children?
Jun 13, 2025
Source: Cainiu Health
Dr. Zhou Xiaofeng
Introduction
Streptococcal infection in children can affect multiple systems. Common symptoms include sore throat, scarlet fever-like rash or impetigo, persistent high fever, abdominal pain with vomiting, and joint pain. The symptoms of streptococcal infection in children are diverse; diagnosis should be confirmed by combining clinical history and laboratory tests. Once infection is suspected, prompt medical attention is necessary to avoid complications such as rheumatic fever and nephritis due to delayed treatment.
In general, pediatric streptococcal infection can affect multiple systems. Common symptoms include sore throat, scarlatiniform rash or impetigo, persistent high fever, abdominal pain with vomiting, and joint pain. A detailed explanation is as follows:
1. Sore Throat
Acute pharyngitis or tonsillitis commonly occurs after infection, presenting with significant throat pain upon swallowing, congested and swollen tonsils, and visible white or yellow purulent discharge on the tonsillar surface. Some children may also present with swollen, tender cervical lymph nodes.
2. Scarlatiniform Rash or Impetigo
Infection with group A streptococcus can cause scarlet fever, characterized by a generalized diffuse red rash. The rash is particularly dense in skin folds, such as the elbow and armpit areas, forming Pastia's lines. The face appears flushed with circumoral pallor. Additionally, skin infection can present as impetigo.
3. Persistent High Fever
Most affected children develop a high fever above 38.5°C, which may persist for 1–3 days. In some cases, medication is required to reduce the fever. Fever may be accompanied by fatigue and reduced appetite.
4. Abdominal Pain and Vomiting
A minority of children may experience gastrointestinal symptoms after infection, such as intermittent abdominal pain, often periumbilical, likely related to intestinal irritation caused by toxins produced by streptococci. Severe cases may involve vomiting and require differentiation from acute abdomen.
5. Joint Pain
If the infection is not promptly controlled, it may lead to rheumatic fever, presenting as migratory pain in large joints or symptoms of palpitations and shortness of breath caused by myocarditis or pericarditis. Some children may also develop acute glomerulonephritis, presenting with hematuria, edema, and decreased urine output.
Pediatric streptococcal infection presents with diverse symptoms, and diagnosis should be based on medical history and laboratory tests. Prompt medical attention is essential once infection is suspected to avoid complications such as rheumatic fever and nephritis due to delayed treatment.
