Strep throat is a common bacterial infection. While responsive to antibiotics, neglecting it can lead to serious health issues. This article explores the complications that can arise if strep throat remains untreated.
Understanding Strep Throat
Strep throat, medically known as streptococcal pharyngitis, is an infection caused by bacteria called Streptococcus pyogenes, also referred to as Group A Streptococcus (GAS). These bacteria are highly contagious and can spread through respiratory droplets from coughing or sneezing. Common symptoms often appear suddenly and include a sore throat, fever, and red, swollen tonsils that may show white patches or streaks of pus. Tiny red spots on the roof of the mouth, known as petechiae, can also be present. While these symptoms can resemble those of a viral infection, accurate diagnosis through a rapid strep test or throat culture is important to confirm the presence of GAS bacteria.
Localized Complications
If left untreated, the bacterial infection can spread beyond the immediate throat area, leading to localized complications. One such complication is a peritonsillar abscess, a collection of pus that forms behind one of the tonsils. This condition can cause severe pain, difficulty swallowing, and a muffled or “hot potato” voice. It is a complication of tonsillitis and is caused by the same bacteria responsible for strep throat.
A more serious localized complication is a retropharyngeal abscess. This deep collection of pus forms behind the pharynx, near the spine, and can be life-threatening if it grows large enough to obstruct the airway. Retropharyngeal abscesses are more common in young children and can stem from an infection that spreads from the throat, sinuses, or adenoids. Symptoms may include fever, difficulty and pain with swallowing, a stiff neck, and noisy breathing.
Another localized issue is cervical lymphadenitis, which involves the inflammation and swelling of lymph nodes in the neck. While often a symptom of the initial infection, persistent or worsening swelling can indicate a more significant localized spread of the bacteria.
Major Systemic Complications
Beyond localized issues, untreated strep throat can lead to systemic complications. A major complication is Acute Rheumatic Fever (ARF), an inflammatory disease that can impact the heart, joints, brain, and skin. ARF is not an infection itself but an autoimmune response where the body’s immune system, in its attempt to fight the strep bacteria, mistakenly attacks healthy tissues. This can occur approximately one to five weeks after an untreated strep infection.
ARF can cause permanent heart damage, a condition known as Rheumatic Heart Disease (RHD). The inflammation can scar heart valves, making them narrow or leaky, which forces the heart to work harder and can eventually lead to heart failure. While ARF is rare in countries with widespread antibiotic access, it remains a significant concern globally.
Another major systemic complication is Post-Streptococcal Glomerulonephritis (PSGN), a kidney disorder. PSGN develops one to two weeks after an untreated strep throat infection. This condition involves the formation of immune complexes, where antibodies triggered by the strep infection deposit in the glomeruli, the tiny filtering units of the kidneys. This deposition leads to inflammation and damage, impairing the kidneys’ ability to filter waste from the blood. Symptoms can include swelling, dark urine, and high blood pressure.
Other Potential Systemic Complications
Untreated strep throat can also be linked to other systemic complications. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a proposed condition where strep infections are thought to trigger or worsen certain neurological or psychiatric symptoms in children. These symptoms often include a sudden onset or exacerbation of obsessive-compulsive disorder (OCD) or tic disorders. The theory suggests that antibodies produced to fight the strep bacteria may mistakenly attack cells in the brain due to molecular mimicry.
Streptococcal Toxic Shock Syndrome (STSS) is a rare but life-threatening condition that can arise from Group A Streptococcus infections, including strep throat. STSS occurs when the bacteria release toxins into the bloodstream, leading to a severe immune reaction that can cause rapid organ failure and shock. While uncommon, STSS is a severe form of strep disease and requires immediate medical intervention.