Strep throat, a common bacterial infection, often raises questions about its resolution without medical intervention. While the immediate discomfort of a sore throat might eventually subside on its own, treatment for strep throat is important. Delaying or forgoing appropriate treatment can lead to serious health complications. This article will explore the nature of strep throat, the significant risks associated with leaving it untreated, and the standard diagnostic and treatment approaches.
Understanding Strep Throat
Strep throat is a bacterial infection caused by Streptococcus pyogenes, also known as Group A Streptococcus (GAS). This bacterium primarily infects the throat and tonsils. Highly contagious, it spreads through respiratory droplets from coughing, sneezing, talking, or singing. Direct contact with nasal discharge or saliva also transmits the bacteria.
Common symptoms of strep throat include:
- Sudden sore throat
- Pain when swallowing
- Fever
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots on the roof of the mouth
- Swollen, tender lymph nodes in the neck
These symptoms can overlap with those of viral infections, underscoring the importance of accurate diagnosis rather than self-diagnosis. Therefore, medical testing is essential to confirm a strep infection.
Risks of Untreated Strep
Leaving strep throat untreated with antibiotics carries a risk of developing severe complications. One complication is rheumatic fever, an inflammatory disease affecting the heart, joints, brain, and skin. It can lead to permanent heart damage, known as rheumatic heart disease, particularly affecting heart valves, which may manifest years later.
Another consequence is post-streptococcal glomerulonephritis (PSGN), a kidney disease. PSGN occurs when the body’s immune response mistakenly attacks the tiny filtering units in the kidneys. Most people recover within weeks, but some adults may experience long-term kidney damage, including chronic kidney disease.
Untreated strep can also lead to localized infections. A peritonsillar abscess, a painful collection of pus behind the tonsils, can make swallowing and opening the mouth difficult. This forms when the infection spreads from the tonsil to surrounding tissue.
More severe, though rarer, complications include the spread of bacteria. This can result in conditions like cellulitis, a deep skin infection, or toxic shock syndrome, a life-threatening condition leading to organ failure. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a proposed condition where a strep infection may trigger or worsen neurological symptoms like obsessive-compulsive disorder or tics in children.
Diagnosis and Treatment for Strep
Diagnosing strep throat accurately is important due to the overlap of its symptoms with viral infections. A physical examination is performed, followed by laboratory tests. The rapid strep test (RST) is a quick diagnostic tool detecting Group A Streptococcus bacteria from a throat swab, providing results within minutes. A positive RST confirms strep throat.
If the rapid strep test is negative, especially in children, a throat culture is performed. This involves sending a swab to a laboratory to grow strep bacteria, taking 1 to 2 days. This method is more accurate than the rapid test, as rapid tests can sometimes produce false-negative results.
Antibiotics are prescribed to treat strep throat. Penicillin and amoxicillin are common first-line antibiotics. These medications prevent severe complications like rheumatic fever and PSGN. They also shorten symptom duration and reduce contagiousness. A typical course lasts 10 days. Completing the entire course, even if symptoms improve, is important to ensure complete bacterial eradication and prevent recurrence or complications.
Symptomatic Relief and When to Seek Medical Attention
While awaiting a strep diagnosis or if a sore throat is determined to be viral, several measures can help manage symptoms. Over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate throat pain and reduce fever. Warm liquids, like tea with honey, can provide soothing relief, though honey should not be given to infants under one year old. Lozenges and humidifiers may also help to ease throat discomfort.
A doctor’s visit is needed if a sore throat is severe, accompanied by difficulty swallowing, or persists for more than 48 hours. Fever, a rash, headache, body aches, nausea, or vomiting, especially in children, are additional signs that require medical evaluation. Anyone who suspects strep throat, particularly children, should be tested to determine if antibiotics are needed.