Strep throat, caused by the bacterium Streptococcus pyogenes (also known as Group A Strep), is a common throat infection. While it may seem like a straightforward illness, untreated strep throat can lead to serious complications. Understanding these consequences is important for preventing more severe conditions.
Understanding Strep Throat
Strep throat is a bacterial infection of the throat and tonsils. Common symptoms include a sudden sore throat, fever, and painful swallowing. Individuals may also notice red and swollen tonsils, sometimes with white patches or streaks of pus, and tiny red spots on the roof of the mouth. Swollen, tender lymph nodes in the neck are also a frequent sign.
Unlike a common cold, which is viral and often presents with a cough or runny nose, strep throat is bacterial and typically lacks these respiratory symptoms. Diagnosis usually involves a rapid strep test or a throat culture. Confirming the presence of Streptococcus pyogenes is important for appropriate treatment.
Immediate Consequences of Non-Treatment
When strep throat goes untreated, the bacterial infection can spread beyond the tonsils and throat, leading to more localized and acute complications. One such complication is a peritonsillar abscess, a collection of pus that forms behind one of the tonsils, causing severe throat pain, difficulty swallowing, and sometimes fever. Similarly, a retropharyngeal abscess, though less common, involves pus accumulation in the deeper tissues at the back of the throat.
The infection can also extend to nearby structures, resulting in otitis media (an ear infection) or sinusitis (inflammation of the sinuses). These conditions arise as the immune system struggles to contain the infection without medical intervention, leading to increased discomfort and requiring more intensive medical care.
Systemic Complications of Untreated Strep
Beyond localized issues, untreated Group A Strep infections can trigger serious, body-wide complications, often due to the immune system’s response to the bacteria. These systemic conditions can affect various organs and systems.
Acute Rheumatic Fever (ARF) is an inflammatory disease that can develop one to six weeks after an untreated strep throat infection. This condition results from an abnormal immune reaction where the body’s defenses mistakenly attack its own tissues, particularly in the heart, joints, brain, and skin.
Heart damage, known as rheumatic heart disease (RHD), can be a permanent consequence of ARF. This can lead to scarred heart valves that may not function properly and potentially cause heart failure.
Post-Streptococcal Glomerulonephritis (PSGN) is a kidney disorder that appears one to two weeks after a strep throat infection. PSGN involves inflammation of the kidney’s filtering units, called glomeruli, which can impair the kidneys’ ability to remove waste and fluids from the blood.
Symptoms include decreased urine output, dark or rust-colored urine, and swelling around the eyes, hands, and feet. While many recover fully, long-term kidney damage can occur.
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a condition where neurological and psychiatric symptoms can emerge or worsen suddenly following a strep infection. This involves an autoimmune response where antibodies produced to fight the strep bacteria may mistakenly affect areas of the brain.
Children with PANDAS may experience a sudden onset or exacerbation of obsessive-compulsive disorder (OCD) or tic disorders. Other associated symptoms can include anxiety, mood changes, hyperactivity, or difficulty sleeping.
Treatment and Prevention of Complications
Treating strep throat promptly with antibiotics prevents both immediate and systemic complications. Healthcare providers prescribe a course of antibiotics, such as penicillin or amoxicillin, which are first-line treatments. For individuals with penicillin allergies, alternative antibiotics like cephalexin, azithromycin, or clindamycin may be prescribed.
Antibiotic treatment alleviates symptoms more quickly and reduces the risk of serious complications like rheumatic fever and kidney inflammation. It also decreases the likelihood of transmitting the infection to others. Completing the full 10-day course of antibiotics is important, even if symptoms improve, to ensure bacteria are fully eradicated and prevent severe post-streptococcal conditions.