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What Causes Pale Pallor When Suffering From Strep Throat?

Posted on Sat, 4 Oct 2014

Question: My daughter has had 2 CBC(finger poke) done and both were normal. She had strep throat a little while back but is still very pale. she has been pale around a month. I'm concerned that there could be something more serious going on and it has been missed.

Answered by Dr. Sumanth Amperayani (13 minutes later)

Brief Answer:
Please send over the images/ test results

Detailed Answer:
Hi...I understand your concern. I don't think the streptococcal sore throat is related to her pallor. But I would like to reassure you because you have mentioned that 2 CBCs done were normal.
I have a few questions for you -
1. Have you observed the pallor even before the strep sore throat?
2. How was streptococcal sore throat diagnosed?
3. What antibiotics were used and for how long?
4. Apart from pallor are there any other signs that are concerning you like - prolonged fever/ excessive fatigability/ swelling of glands in the neck or groin/ abdominal distension/ loss of appetite/ excessive unexplainable weight loss etc.
5. Send me over the images of the blood tests and if possible an image of your son.

Kindly get back with the above details and I will be glad to help you.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (29 minutes later)

CBC results were; gran: 5.1, Hematocrit: 36.7, Hemoglobin: 12.1, Lymphs(absolute):5.9, MCHC:33.0, Platelets:395, WBC: 11.0. I did notice the pallor before strep. a week before. Strep was not tested, the FNP looked in her throat and seen pus pockets. azithromycin was given for, four days. She has not been as active as she was before the pallor set in. I find her watching a complete movie when before she would only watch 10 mins of a movie and want outside. I'm having trouble getting her outside now. She is constantly wanting me to hold her and also wakes at night screaming. She has one Lymph node on her neck that is swollen doctor checked it and said it was normal but i noticed it is larger that has ever been and it also became larger when the pallor set in. She has also been experiencing constipation. she has never had a problem with that before.

I'm also wandering if a finger prick cbc is as accurate as vein.?

Answered by Dr. Sumanth Amperayani (14 minutes later)

Brief Answer:
Looks like a prolonged viral illness

Detailed Answer:
Hi..looks like its is not a just simple streptococcal sore throat.

I suggest you have your daughter have a second look at by a different paediatrician and quote the whole history and all the questions I have asked you and what you have answered. I think it is a prolonged viral illness which is causing this node swelling.

Coming to your query about - finger prick cbc is as accurate as vein.? - it all depends on the technician who is doing the stuff and reading the slide prepared from the blood drop.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (5 minutes later)

i did already take her to two different doctors. What i'm concerned most with is her pallor.

Answered by Dr. Sumanth Amperayani (5 minutes later)

Brief Answer:
Do not worry about pallor - wait for 2 weeks

Detailed Answer:
HI...her haemoglobin is 12.1 and even if margin of error is taken (due to individual technician who is seeing the blood result) you need not worry about the pallor.
You can give it a 2 weeks try for her to settle herself out of this. Meanwhile you can give her iron rich foods like dates and dates syrup and green leafy vegetables etc.
If after 2 weeks if you still feel that she is pale then get her checked by a paediatrician again. But I am sure that she is in convalescence and will definitely be well by then.
Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar