Topic Overview

Complications of strep throat are rare but can occur, especially if strep throat is not properly treated with antibiotics. Complications can be related either to the strep infection or to the body’s immune response to the infection.

Complications related to the strep infection

Although rare, complications can result from the strep infection spreading to other areas of the body. Infection can spread to the:

• Middle ear (otitis media).
• Sinuses (sinusitis).

Other, more rare, complications include:

• Infection behind the pharynx (retropharyngeal abscess).
• Infection of the lymph nodes of the neck.
• A peritonsillar abscess.
• Toxic shock syndrome.

Complications related to the body’s immune response to strep bacteria

Sometimes in response to a strep infection, the body’s immune system will attack healthy tissues, causing complications such as rheumatic fever, inflammation of the kidneys (glomerulonephritis), or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

• In rare cases, untreated strep may progress to rheumatic fever. Antibiotic therapy begun as late as 9 days after the start of a strep infection will prevent rheumatic fever.
• Glomerulonephritis may occur after infection with certain strains of strep bacteria. These infections may include a strep infection of the skin (such as impetigo), usually during the summer months, or the throat (such as strep throat), usually during the winter months. The condition is relatively rare and goes away without treatment. But some complications may require treatment. Treatment of strep infection may not prevent inflammation of the kidneys.
• PANDAS is a term used to describe what happens with some children who have symptoms of certain disorders that get worse following infections such as strep throat or scarlet fever. The disorders whose symptoms get worse include obsessive compulsive disorder (OCD) and tic disorders such as Tourette’s syndrome.