Strep throat is a common bacterial infection affecting the throat and tonsils. It is caused by Group A Streptococcus (Streptococcus pyogenes) and spreads easily through respiratory droplets or shared items. Unlike many viral sore throats, strep throat is bacterial.
Natural Progression of Strep Throat
Without antibiotics, strep throat symptoms usually last three to five days, though they can persist for up to a week. Symptoms often appear suddenly, two to five days after exposure. Common signs include a severe sore throat, pain when swallowing, and fever.
The throat and tonsils may appear red and swollen, sometimes with white patches or pus. Small red spots (petechiae) might also be visible on the roof of the mouth. While symptoms may improve, the bacteria can remain for several weeks, meaning an individual can still be contagious for two to three weeks without treatment.
Serious Risks of Untreated Strep Throat
Untreated strep throat carries a risk of serious complications, developing within days to weeks after the initial infection. These occur because the Streptococcus bacteria can spread or trigger an immune response harming distant organs. One potential complication is acute rheumatic fever, a severe inflammatory condition appearing two to three weeks after infection. This can affect the heart, joints, nervous system, and skin, potentially leading to long-term heart valve damage.
Another serious risk is post-streptococcal glomerulonephritis, an inflammation of the kidneys developing one to three weeks after infection. While often resolving on its own, some cases may require treatment or lead to kidney failure. Localized infections can also occur, such as a peritonsillar abscess, a collection of pus behind a tonsil causing severe throat pain and difficulty swallowing. Other complications include toxic shock syndrome and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
Why Antibiotics Are Essential
Antibiotics are essential for strep throat as they directly eliminate the Group A Streptococcus bacteria. This treatment significantly reduces symptom duration and severity, often leading to improvement within one to two days. Penicillin and amoxicillin are common prescriptions, typically taken for a 10-day course to ensure full eradication.
Beyond symptom relief, antibiotics prevent serious complications like acute rheumatic fever and peritonsillar abscesses. Starting antibiotics within 48 hours of symptom onset is effective in preventing these issues. Antibiotic treatment also reduces contagiousness, making individuals less likely to spread the infection within 24 hours of starting medication.
When to Consult a Doctor
Consult a doctor if you experience symptoms suggesting strep throat. A sudden sore throat, especially with a fever of 101°F or higher, warrants a visit. Other symptoms include painful swallowing, red and swollen tonsils (often with white patches or pus), tiny red spots on the roof of the mouth, swollen neck lymph nodes, headache, or a rash.
It is important to consult a doctor if a sore throat lasts longer than 48 hours, if symptoms worsen after three days, or if there are difficulties breathing or swallowing. For children, any symptoms under age two, or a fever over 102°F in children under six, should prompt medical evaluation. Prompt diagnosis, often through a rapid strep test or throat culture, is important to prevent complications.