Strep throat is a common bacterial infection caused by Streptococcus pyogenes, also known as Group A Streptococcus (GAS). This bacterium often resides on a person’s skin, nose, or throat. While many carry it without illness, it can cause various conditions. It is prevalent among children aged 5 to 15, with an estimated 600 million cases globally each year. The infection spreads through respiratory droplets, such as those from coughing, sneezing, or sharing utensils, and can remain contagious for up to three weeks if left untreated.
Immediate Local Complications
If strep throat remains untreated, the infection can spread to nearby tissues, leading to localized complications. One is a peritonsillar abscess, a painful collection of pus behind a tonsil. This abscess can cause severe pain, difficulty swallowing, a muffled voice, and may lead to airway obstruction if it swells significantly.
The infection can also extend into the ears, causing otitis media, or middle ear infection. This condition presents with ear pain, fever, and sometimes temporary hearing loss. Additionally, untreated strep throat can spread to the sinuses, resulting in sinusitis, an inflammation of the sinus cavities. Sinusitis can cause facial pain or pressure, nasal congestion, and headaches.
Systemic Complications
Beyond localized issues, untreated strep throat can trigger severe, body-wide consequences due to the immune system’s response. One serious condition is Acute Rheumatic Fever (ARF), an inflammatory disease affecting the heart, joints, brain, and skin. ARF develops one to five weeks after a strep throat infection and can lead to permanent heart valve damage, known as rheumatic heart disease. Symptoms include painful, migratory joint inflammation, a characteristic rash, and involuntary movements.
Another systemic complication is Post-Streptococcal Glomerulonephritis (PSGN), a kidney disorder. PSGN occurs when the immune system forms antigen-antibody complexes that deposit in the kidney’s filtering units, the glomeruli, leading to inflammation. This condition appears one to three weeks after a strep throat infection and can cause symptoms such as dark or brownish urine, swelling, and high blood pressure. While most children recover fully from PSGN, some, particularly adults, may develop long-term kidney problems, including chronic kidney disease.
Importance of Diagnosis and Treatment
Prompt diagnosis and appropriate antibiotic treatment are important in managing strep throat. Administering antibiotics within 48 hours of symptom onset can significantly reduce symptom duration and severity. This early intervention also prevents the spread of infection to others, as individuals become less contagious after 24 hours of antibiotic treatment.
Treatment with antibiotics is also the primary method for preventing both immediate local complications and more severe systemic complications, such as rheumatic fever and post-streptococcal glomerulonephritis. Completing the full course of prescribed antibiotics, even if symptoms improve quickly, is important to ensure all bacteria are eliminated and to minimize the risk of recurrence or serious health issues.