Strep throat 101
Sore throats are common, especially during cold and flu season. But when the culprit is strep throat, caused by group A Streptococcus bacteria, treatment becomes more important. Untreated strep can lead to serious complications in both children and adults.
Here’s what to watch for, how to treat it, and when to seek medical attention.
What is strep throat?
Strep throat is a bacterial infection of the throat and tonsils. It spreads through respiratory droplets. Those coughs, sneezes or contact with shared surfaces can all transmit the infection. While anyone can get strep throat, it’s most common in children ages 5 to 15.
Signs and symptoms of strep throat
In both children and adults, symptoms may include:
- Sudden, severe sore throat
- Pain when swallowing
- Fever over 101°F
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots (petechiae) on the roof of the mouth
- Swollen, tender lymph nodes in the neck
- Headache, body aches or rash
- Nausea or vomiting (more common in children)
Note: Cough, runny nose and hoarseness are more often signs of a viral infection, not strep.
Diagnosis and treatment
“Strep throat is diagnosed through tests like a rapid strep test, a strep DNA test, or a throat culture at a doctor’s office,” said SIU pediatrician Tracy Milbrandt, MD. “If it’s positive, antibiotics like penicillin or amoxicillin are prescribed to reduce symptoms, prevent complications, and limit its spread to others. Without treatment, symptoms may go away in a few days, but the bacteria can still cause harm to the body.”
When to seek medical attention
Like any illness, it’s critical to seek medical attention so you can feel better and the illness doesn’t progress to something worse. Make an appointment with your primary care provider or visit Express Care if:
- You or your child has a sore throat with fever lasting more than 48 hours
- There is difficulty swallowing or breathing
- A rash develops along with the sore throat
- Symptoms improve with treatment but then return
- A child shows unusual behavior changes, such as obsessive-compulsive behavior or emotional outbursts (more on that below)
Complications of untreated strep throat
Skipping treatment or stopping antibiotics early can lead to serious complications. While not commonly discussed, scarlet fever, rheumatic fever and other more serious conditions can still happen if strep throat is left untreated.
Scarlet fever - This illness includes the classic strep symptoms plus a red, sandpaper-like rash, usually starting on the chest and spreading outward. It’s most common in children and requires antibiotic treatment to prevent further issues.
Rheumatic fever - Rheumatic fever is a rare but serious condition that can develop weeks after untreated strep. It can affect the heart, joints, brain and skin.
Post-streptococcal glomerulonephritis - This condition affects the kidneys and may cause swelling, blood in the urine and high blood pressure.
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) - PANDAS is a rare complication that occurs in children, typically between ages 3 and 12. It involves a sudden onset of obsessive-compulsive behaviors, anxiety, tics or emotional changes following a strep infection. PANDAS is believed to be an autoimmune response to strep bacteria that affects the brain.
If you suspect PANDAS, talk to your pediatrician. Early recognition and treatment are crucial.
Preventative tips
- Wash hands frequently, especially before eating and after coughing or sneezing.
- Avoid sharing food, drinks or utensils.
- Stay home from work, school or daycare until 24 hours after starting antibiotics.
- Replace toothbrushes after 24-48 hours of antibiotics to reduce reinfection.
If you’re unsure whether it’s just a sore throat or something more, it’s worth getting checked out. SIU Medicine’s family medicine and pediatric providers are here to diagnose and treat strep and support your health at every stage of life.
