Can Streptococcal (strep) infection cause headaches?

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From the Guidelines

Yes, strep infections can cause headaches, as evidenced by the clinical findings suggestive of GAS as the cause of an episode of acute pharyngitis, which include sore throat, pain on swallowing, fever, and headache 1.

Clinical Presentation

The headache occurs as part of the body's inflammatory response to the bacterial infection. As the immune system fights the strep bacteria, it releases chemicals that can cause pain and inflammation throughout the body, including in the head.

  • Headaches may range from mild to severe and often accompany other symptoms like:
    • Swollen tonsils
    • Difficulty swallowing
    • Tender lymph nodes in the neck

Diagnosis and Treatment

If you suspect a strep infection, it's essential to see a healthcare provider for proper diagnosis, typically through a rapid strep test or throat culture 1.

  • Treatment usually involves antibiotics such as penicillin or amoxicillin for a full 10-day course, even if symptoms improve earlier.
  • Completing the entire antibiotic regimen is crucial to prevent complications like rheumatic fever or kidney inflammation.
  • Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage headache pain and fever while the antibiotics work to clear the infection.

Key Considerations

It's also important to note that while strep infections can cause headaches, not all headaches are caused by strep infections. A proper diagnosis by a healthcare provider is necessary to determine the cause of the headache and appropriate treatment.

  • The clinical findings and diagnosis of strep infections are supported by studies published in reputable journals, such as the American Heart Association and the Infectious Diseases Society of America 1.

From the Research

Streptococcal Infection and Headaches

  • Streptococcal infection can cause a range of symptoms, including headaches, as noted in a study on streptococcal acute pharyngitis 2.
  • The study found that symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate.
  • Another study investigated the relationship between streptococcal infection and meningismus in children suffering from chronic headaches, and found that a majority of children with headaches associated with meningismus had evidence of a streptococcal infection 3.
  • This suggests that streptococcal infection may play an important role in the etiology of meningismus-positive chronic headaches in children.
  • Headaches can also be attributed to infectious diseases, including streptococcal infections, as noted in a review of headaches attributable to infectious diseases 4.
  • However, not all studies specifically mention headaches as a symptom of streptococcal infection, such as a study on group A streptococcal infections in children, which found that fever was the most common presenting symptom 5.
  • A study on streptococcal pharyngitis also did not mention headaches as a common symptom, but rather focused on the diagnosis and treatment of the infection 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Streptococcal acute pharyngitis.

Revista da Sociedade Brasileira de Medicina Tropical, 2014

Research

Headaches attributable to infectious diseases.

Current pain and headache reports, 2010

Research

Group A Streptococcal Infections in Children.

Current pediatric reviews, 2021

Research

Streptococcal Pharyngitis: Rapid Evidence Review.

American family physician, 2024

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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