Streptococcal pharyngitis: boys more likely than girls to present with abdominal pain

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Takeaway

  • Abdominal pain and nausea may predict Group A streptococcal (GAS) pharyngitis in male pediatric patients, but not females.

Why this matters

  • Young children suffering from GAS do not always complain of a sore throat, according to one study.
  • Children <3 y may not present with other typical GAS symptoms like anterior cervical lymphadenopathy and tonsillar exudates.
  • Gastrointestinal (GI) symptoms such as pain are common in children with GAS, but studies attempting to use GI symptoms to predict GAS have been inconsistent.

Study design

  • Retrospective cross-sectional study of 5755 children, aged <15 y presenting with fever between June 1, 2011 and January 18, 2015.
  • Funding: None.

Key results

  • 331 patients were coded as having GAS pharyngitis, who were either clinically detected (n=113) or diagnosed with rapid tests (n=218).
  • Among children with abdominal pain, rapid test confirmed GAS pharyngitis in 9.2% (11/120) of boys vs 2.3% (3/128) of girls (P=.026).
  • Among children with nausea, 10.3% (7/68) of boys and 4.0% (2/50) of girls were confirmed with GAS pharyngitis (P=.30).
  • No child under <3 y having abdominal pain or nausea was confirmed with GAS pharyngitis.

  Limitations

  • Sensitivity of rapid test is lower than throat culture.

 

Coauthored with Anand Ramanathan, PharmD