Strep throat, a common bacterial infection caused by Streptococcus pyogenes (also known as Group A Streptococcus or GAS), primarily affects the throat and tonsils. While treatable with antibiotics, leaving it untreated can lead to severe health complications. These issues extend beyond the initial sore throat, impacting various body systems and potentially causing long-term health concerns. Understanding these complications highlights the importance of prompt diagnosis and appropriate medical intervention.
Immediate Localized Issues
Untreated strep throat can lead to the spread of the infection to tissues immediately surrounding the throat. One such complication is a peritonsillar abscess, a collection of pus behind a tonsil. This abscess can cause intense pain, swelling, and make it difficult to open the mouth, swallow, or even speak. If the abscess grows too large, it can potentially obstruct the airway, making breathing challenging.
Another localized issue involves a retropharyngeal abscess, a collection of pus deep in the back of the throat, typically affecting lymph nodes in that area. This condition is more common in young children and can present with symptoms such as difficulty swallowing, fever, a stiff neck, and noisy breathing. A retropharyngeal abscess can lead to airway obstruction, aspiration pneumonia if it ruptures, or spread of the infection to the chest.
Acute Rheumatic Fever
Acute rheumatic fever (ARF) is an inflammatory condition that can affect the heart, joints, brain, and skin. ARF is an autoimmune response where the body’s immune system mistakenly attacks its own tissues. This occurs because certain proteins on the strep bacteria are structurally similar to proteins found in human tissues, a phenomenon known as molecular mimicry.
Heart involvement, known as rheumatic heart disease (RHD), can lead to permanent damage to the heart valves. While ARF symptoms like joint pain, fever, or skin rashes may resolve, the cardiac damage can persist and worsen with repeated strep infections. RHD can result in heart failure, irregular heart rhythms, and other cardiac issues over a lifetime.
Post-Streptococcal Glomerulonephritis
Post-streptococcal glomerulonephritis (PSGN) is a kidney condition that can follow an untreated strep infection. PSGN involves inflammation of the glomeruli, the tiny filtering units within the kidneys. This inflammation can impair the kidneys’ ability to properly filter waste and excess fluid from the blood.
Symptoms of PSGN can include swelling, particularly around the eyes and in the hands and feet, due to fluid retention. Individuals may also notice dark, reddish-brown urine, often described as “cola-colored,” indicating the presence of blood. High blood pressure is another common symptom, resulting from the kidneys’ reduced function. While most people, especially children, recover fully from PSGN within weeks to months, a small percentage of adults can experience long-term kidney problems, including chronic kidney disease or, in rare cases, kidney failure.
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a condition where a strep infection can trigger or worsen certain neuropsychiatric symptoms in children. The primary symptoms associated with PANDAS include the sudden onset of obsessive-compulsive disorder (OCD) or tic disorders. These symptoms often appear abruptly, within days of a strep infection.
The mechanism behind PANDAS is thought to involve an autoimmune response, similar to that seen in acute rheumatic fever, where antibodies produced to fight the strep bacteria mistakenly attack parts of the brain, particularly the basal ganglia. This cross-reaction can lead to a range of behavioral and neurological changes, which may also include anxiety, mood swings, irritability, and a decline in school performance.
Preventing Serious Complications
Preventing serious complications of strep throat relies on timely diagnosis and appropriate treatment. If strep throat is suspected, seek medical attention promptly. Healthcare providers can perform a rapid strep test or a throat culture to confirm the presence of Group A Streptococcus bacteria.
Once diagnosed, antibiotics are prescribed to eliminate the bacterial infection. Taking antibiotics within 48 hours of symptom onset can prevent the development of complications like acute rheumatic fever and peritonsillar abscesses. It is important to complete the entire course of antibiotics as prescribed, even if symptoms improve, to ensure all bacteria are eradicated and to prevent potential recurrences or the onset of late complications.