Strep throat is a common bacterial infection that affects the throat and tonsils. It is caused by the bacterium Streptococcus pyogenes, also known as Group A Streptococcus (GAS). While the body’s immune system can fight off many infections, strep throat requires medical intervention. Leaving strep throat untreated carries a risk of developing serious complications.
Understanding Strep Throat
Streptococcus pyogenes is a highly contagious bacterium. It spreads through respiratory droplets when an infected person coughs, sneezes, talks, or shares food and drinks. People can also contract the bacteria by touching contaminated surfaces and then touching their nose, mouth, or eyes. Symptoms appear 2 to 5 days after exposure and can range from mild to severe.
Common symptoms include a sore throat that comes on quickly, painful swallowing, and a fever. The tonsils may appear red and swollen, sometimes with white patches or streaks of pus. Tiny red spots, known as petechiae, might be visible on the roof of the mouth. Swollen, tender lymph nodes in the neck are also common.
Risks of Untreated Strep Throat
Leaving strep throat untreated can lead to health problems, as the body’s immune response to the bacteria can mistakenly attack healthy tissues. One complication is Acute Rheumatic Fever (ARF), an inflammatory condition that can affect the heart, joints, brain, and skin. ARF develops two to three weeks after a strep infection and can cause painful, migratory arthritis. Heart inflammation, or carditis, occurs in up to half of ARF patients and can lead to chronic heart disease and even heart failure.
Another complication is Post-Streptococcal Glomerulonephritis (PSGN), a rare kidney disease that can develop a week or two after a strep throat infection. PSGN is more common in children and can lead to symptoms like swelling, high blood pressure, and dark urine. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a condition that primarily affects children. PANDAS can trigger or worsen obsessive-compulsive disorder (OCD) and tic disorders, with symptoms having a dramatic and abrupt onset or fluctuation.
Untreated strep throat can lead to a peritonsillar abscess, a collection of pus behind the tonsils. This condition can cause throat pain, difficulty swallowing, and muffled voice. These complications highlight why medical intervention with antibiotics is necessary for strep throat, as the body’s natural defenses alone may not prevent these outcomes.
Diagnosis and Treatment
Diagnosing strep throat involves a medical evaluation and tests. A healthcare provider will examine the throat for redness, swelling, and white patches, and check for swollen lymph nodes. To confirm the presence of Group A Streptococcus bacteria, a throat swab is taken for testing.
The two main types of tests are a rapid strep test and a throat culture. A rapid strep test detects bacterial antigens and can provide results within 10 to 20 minutes. If the rapid test is positive, strep throat is confirmed, and antibiotic treatment can begin.
If the rapid test is negative but strep throat is still suspected, a throat culture may be performed. This involves sending the swab to a laboratory to see if Streptococcus bacteria grow, which can take 24 to 48 hours. Throat cultures are more sensitive and can identify infections missed by rapid tests.
Once strep throat is diagnosed, antibiotics are the standard treatment. Penicillin and amoxicillin are commonly prescribed for a 10-day course. It is important to complete the entire course of antibiotics, even if symptoms improve within a few days, to fully eradicate the bacteria and prevent complications like rheumatic fever and kidney inflammation. While antibiotics address the infection, supportive care such as pain relievers like acetaminophen or ibuprofen can help manage throat pain and fever, and rest and hydration are also beneficial.