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Does my son have a streptococcal infection?

Q: My son who is 3 years 7 months develops fever on and off (102F). With sore throat pain mild sneezing on examination he was found to have congested pharynx with 4-5 pus lesions on the tonsils. He was prescribed amoxycillin 250 mg meftal-p tds and on the same night he vomited after severe coughing and crying. The food content contained small amounts of clotted blood. The second day meftal was stopped and there was no vomiting. Is it streptococcal infection? I am worried about post streptococcal complication.

A:The gold standard for diagnosing streptococcal infection is a microbial isolation by culture. At this stage, after having received antibiotics, the culture could be negative. Thus we cannot at this stage be certain that it was streptococcal infection since many other infections including viruses can give rise to pus points. If the child is improving and the fever has subsided, I would leave him alone. However, the best advise can only be provided after a clinical examination and/or performing relevant investigations.

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