Caused by bacterial infections, strep throat refers to the inflammation and swelling of the throat, tonsils, and lymph nodes. While sore throats are caused by viral infections, strep throat develops due to bacterial infections of the streptococcus bacterium. If left untreated, you may have to deal with complications varying from mild to serious.

Strep Throat Complications

Group A streptococcus (GAS) bacteria are responsible for causing strep throat. GAS can cause mild illnesses such as strep throat – the bacteria may also cause illnesses with life-threatening consequences, such as streptococcal toxic shock syndrome or necrotizing fasciitis.

Possible Complications Related to the Infection

While there are fewer chances of experiencing strep throat complication, things can go wrong at times. Some complications occur due to the infection itself, but sometimes, you experience complications when your immune system responds erratically to the condition. Here are some strep throat complications caused by the infection:

• Sinusitis: The hollow spaces in your skull around the nose and eyes are called the sinuses. You may experience severe pain with some pressure on your face and head when the sinuses become infected. The condition usually resolves on its own, but you may have to take antibiotics in some cases.
• Middle ear infections (otitis media): Both viruses and bacteria can cause inner ear infections. These bacteria travel from your throat to the inner ear through Eustachian tube. In this case, the fluid that normally drains into your throat starts going up into the ear and accumulates against the eardrum.
• Infections of the pharynx:  Also called retropharyngeal abscesses, they are one of many strep throat complications caused due to the collection of pus in the back of your throat. It is important to drain it first and then take antibiotics for proper treatment.
• Toxic shock syndrome: While it is quite rare, the condition may have life-threatening consequences. It develops suddenly after you become infected with streptococcus pyogenes. It affects different organ systems in your body, including the kidneys, lungs, and liver. The most common symptoms of TSS including vomiting, high fever, and diarrhea – you may also develop a rash like sunburn with low blood pressure, dizziness, and confusion. You need immediate medical attention because toxic shock syndrome progresses fast.
• Peritonsillar abscesses: The condition is characterized by a collection of pus in tissues around your tonsils. It is quite rare, but may be one of many strep throat complications. It causes severe pain and makes it difficult to swallow food. Your doctor will make a diagnosis with the help of a needle aspiration, which is a procedure that involves using a needle to drain the abscess. When a needle aspiration does not work, you may have to opt for a minor surgical procedure that involves making a small incision in the abscess to drain it. You will also need to complete a course of antibiotics.

Possible Complications Related to the Body's Immune Response

Infection itself can cause several issues, but your body's immune system may react to the infection and produce undesirable symptoms and issues. In serious cases, your immune system may start attacking healthy tissues when it finds untreated strep infections in the body. When this happens, you find yourself dealing with a number of serious issues:

• Acute rheumatic fever: It is one of the most serious complications of strep throat. In this, your immune system releases antibodies that mistakenly attack your skin, joints, and the heart. This causes damage to the heart valves that often results in congestive heart failure. The availability of antibiotics has made this condition less common in the United States, but it still affects people to some extent. Symptoms associated with rheumatic fever usually appear in 2-4 weeks after the onset of strep throat.
• Scarlet fever: It may affect people with strep throat and causes symptoms such as sore throat, fever, and a characteristic red rash. The rash feels quite like sandpaper and usually affects children under the age of 18. There are antibiotics available for its treatment.
• Inflammation of the kidneys: Also called glomerulonephritis, it develops when your immune system produces antibodies to the microscopic filters of your kidneys. The condition usually affects children from 7 to 10 years of age. Several therapies are now available to help children recover and most of the time, there are no long-term effects or kidney damage associated with glomerulonephritis.
• Pediatric autoimmune neuro disorders associated with streptococcal infections (PANDAS): Many experts are still trying to identify the links between a GAS infection and the development of obsessive compulsive behavior in people, especially in children. It is also believed that there is a connection between a GAS infection in children and tic disorder. Researchers are also trying to discover if antibiotic therapy proves beneficial in the treatment of this disorder.

When to See a Doctor

It is important to see a doctor if you experience strep throat complications. You should go talk to your doctor or take your child to a doctor if you notice the following signs and symptoms:

• A sore throat with swollen lymph nodes
• A sore throat that does not improve in 48 hours
• A fever higher than 101F with no improvement in 48 hours
• A sore throat with a red rash
• Difficulty swallowing or problems breathing
• No improvement for 24-48 hours after taking antibiotics for strep

You should also talk to your doctor if you or your child has a fever with swelling in the joints. Shortness of breath should not be ignored either. If a strep infection lasts longer than three weeks, it may indicate rheumatic fever.