Strep throat is a common bacterial infection caused by Streptococcus pyogenes, also known as Group A Streptococcus. While many sore throats are viral and resolve on their own, strep throat’s bacterial origin makes it distinct. This distinction is significant because, if left untreated, strep throat carries potential risks beyond a simple sore throat.
Understanding Strep Throat
Strep throat primarily affects the throat and tonsils. The bacterium spreads readily through respiratory droplets when an infected person coughs, sneezes, or talks. Symptoms often appear suddenly and include a painful sore throat, fever, and difficulty swallowing. White patches or streaks of pus on the tonsils are also characteristic signs of the infection.
Immediate Complications of Untreated Strep
Untreated strep throat can spread to nearby tissues, leading to immediate complications. A peritonsillar abscess is a collection of pus that forms behind a tonsil, causing severe throat pain, difficulty opening the mouth, and muffled speech. A retropharyngeal abscess, an infection in the deep tissues at the back of the throat or neck, is dangerous due to its proximity to the airway.
The infection may also extend into the sinus cavities, causing sinusitis, or into the middle ear, causing otitis media. These conditions result in pain, pressure, and inflammation. The bacteria can also cause cellulitis, a bacterial skin infection appearing as a red, swollen, and tender area on the neck or surrounding regions. These complications are generally treatable with prompt medical intervention, often requiring drainage in addition to antibiotic therapy.
Serious Systemic Complications
Untreated strep throat can trigger systemic complications affecting other body parts. These are caused by the body’s immune response to the infection, rather than direct bacterial invasion. Acute Rheumatic Fever (ARF) is a severe inflammatory disease that can develop two to four weeks after an untreated strep infection. ARF can damage heart valves, leading to rheumatic heart disease. It can also cause painful joint swelling, skin rashes, and neurological symptoms like Sydenham’s chorea. This condition is largely preventable with timely antibiotic treatment of strep throat.
Another complication is Post-Streptococcal Glomerulonephritis (PSGN), an inflammation of the kidney’s filtering units (glomeruli). PSGN appears one to three weeks after a strep infection. Symptoms include dark, tea-colored urine, swelling in the face and extremities, and high blood pressure. While most individuals recover fully, some may experience long-term kidney damage or, rarely, kidney failure. The immune system’s reaction to the strep bacteria is believed to trigger this kidney inflammation.
A link exists between strep infections and certain neurological conditions in children, known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). In some susceptible children, a strep infection may trigger or worsen sudden-onset obsessive-compulsive disorder (OCD) or tic disorders. This connection, while still under research, represents another potential severe, albeit less common, systemic consequence.
The Importance of Early Diagnosis and Treatment
Given the potential for serious complications, early diagnosis and treatment of strep throat are important. Antibiotics effectively eliminate Group A Streptococcus bacteria, preventing complications. A healthcare professional can diagnose strep throat using a rapid strep test, which provides quick results, or a throat culture, which is more accurate but takes longer.
Administering antibiotics within 48 hours of symptom onset is particularly effective in preventing acute rheumatic fever. This timely treatment helps avoid the dangers of an untreated infection, safeguarding against both immediate and long-term health problems.