Strep Throat - Complications

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What are the potential complications of strep throat?

The possible complications of strep throat include:

  • Acute rheumatic fever (see below),
  • Glomerulonephritis (see below),
  • Otitis media (middle ear infection),
  • Toxic shock syndrome (a rare but severe complication which may result in the failure of multiple organs and may thus be fatal),
  • Peritonsillar abscess or retropharyngeal abscess (walled off infection containing GAS bacteria and pus which may encroach upon the structures in the back of the throat or invade and rupture into deeper structures which may ultimately be fatal), and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep) - (see below).

Acute rheumatic fever (ARF): While rare, this complication of an untreated or inadequately treated strep infection can have devastating and lifelong consequences. It is believed that due to incomplete eradication of the strep bacteria, certain GAS cause an immune response which may attack the joints leading to permanent arthritis. More concerning is the autoimmune response to the heart valves which may damage them and may result in heart failure. Many studies have shown that effective and appropriate antibiotic therapy for strep throat vastly reduces the likelihood of developing ARF.

Glomerulonephritis: Similar to the aberration of the immune response seen with ARF, autoantibodies may develop to the microscopic filters (glomeruli) of the kidney. This complication more commonly affects children between 7 to 10 years of age. While more common than acute rheumatic fever, glomerulonephritis carries a less ominous prognosis. Helpful therapies exist and most children make a complete recovery and do not experience long-term kidney damage. Unlike ARF, the development of glomerulonephritis is not necessarily prevented by effective antibiotic treatment.

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep): Specialists debate the proposed link of a GAS infection in children with the development and/or worsening of obsessive-compulsive behaviors or tic disorder (Tourette's syndrome in the extreme). One area being researched in this controversial condition is whether antibiotic therapy affects the development of or severity of the disorder.

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See what others are saying

Comment from: vitalizergirl, 75 or over Female (Patient) Published: August 05

I had a very bad sore throat for only 4 days and then it went away. The first day it was very bad and I thought, 'I wonder if this is strep'. I figured I'd wait another day and see if any symptoms of a virus might appear. Day 2 until day 4 no symptoms of a virus appeared, however I had never had a sore throat quite like this. In hindsight I should have gone for a throat culture. It hurt when I swallowed, so I tried not to swallow much. Day 4, no more sore throat, but one week later I wound up in the hospital with 104.5 temperature, severe pain in lower back, and shaking violently. Bacteria had gotten into my blood stream and I was diagnosed with bacteremia or sepsis. I was in the hospital 1 week, released home and I gave myself an IV daily of a very strong antibiotic for 3 months. The bacteria got into the base of my spine and caused an abscess. All of this occurred on 3/17/14, and I will have another MRI with and without enhancement the end of this month (August) to see if the abscess is all cleared up. I was told that this was very serious and I am blessed to be alive.

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Comment from: Mimi, 55-64 Female (Patient) Published: December 15

I started showing symptoms on a Thursday afternoon with a sore throat, but by midnight I had a terrible headache, my heart was racing (119 bpm), I couldn't sleep, sick at my stomach, couldn't eat and had severe muscle pain. I went to a clinic Saturday and was diagnosed with bacterial strep throat. I started antibiotics but by that night the muscle pain had progressed to be stabbing pains in various parts of my body including my head. After getting 3 antibiotics in my system I was able to finally get down some soup. I am still in pain but not as severe.

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