Dangers of Untreated Strep Throat

Medically Reviewed By William C. Lloyd III, MD, FACS
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You wake up with a sore, scratchy throat. How worried should you be? Sore throats are common and are most often caused by viruses, such as the cold or flu. Often, these illnesses are relatively mild and don't require a doctor's intervention. However, some sore throats are a sign of a bacterial infection—specifically, strep throat, caused by group A Streptococcus. This is one sore throat you don't want to ignore, because it can lead to potentially serious complications when left untreated.

How can you tell if your sore throat symptoms warrant a doctor's visit?

Children are most at risk for developing strep throat, especially those ages 5 to 15. Up to 30% of pediatric sore throats are caused by strep, compared to 10% in adults.

Medical authorities have different recommendations for children and adults regarding when to see a doctor for a sore throat. Most viral sore throats will get better after 5 to 7 days, so a big red flag for both you or your child is if the pain lasts longer than this.

If your child has a sore throat but is too young to tell you about their symptoms, look for clues to its severity, such as whether your child is refusing to eat or drink, prefers soft foods to hard ones, has a fever, or is experiencing nausea or vomiting. The American Academy of Pediatrics recommends seeing a doctor right away if your child has symptoms of inability to swallow, which include:

  • Difficulty breathing
  • Unusual or excessive drooling

For adults, the American Academy of Otolaryngology says it's time to call your doctor when your throat pain is severe or lasts beyond a week. Other signs that you need to stop ignoring your sore throat include such strep throat symptoms as:

  • Difficulty breathing, swallowing or opening your mouth
  • Fever higher than 101 degrees Fahrenheit
  • Ear pain
  • Rash
  • Blood in saliva or phlegm

Another reason to seek medical attention for a sore throat is that it can be a symptom of the novel coronavirus (COVID-19). The disease has a variety of other symptoms, as well. The U.S. Centers for Disease Control and Prevention (CDC) has a special coronavirus self-checking tool on its website. Another option is the Healthgrades Coronavirus HealthChat, which can help you determine if you should seek testing based on your symptoms and other factors.

If your doctor suspects you have a strep throat infection, you may be tested with either a rapid-result test (which is quick but sometimes can't detect the bacteria) or a throat culture, which can take a day or two for results. Once you're diagnosed with strep throat, your healthcare provider will prescribe an antibiotic and should see symptoms resolve in a couple of days. In cases with high clinical suspicion for strep antibiotics may be immediately started pending culture results.

It's important for you (or your child) to continue taking the antibiotic until the medicine is finished, to ensure that complications from untreated strep throat don't occur. If your or your child’s symptoms do not improve within 48 hours of starting antibiotics, call your doctor.

What complications can arise from untreated strep throat?

If you have strep throat and don't get antibiotics to knock out the bacteria, the infection could travel to other parts of your body. This could cause a variety of complications, including:

  • Abscesses (infected pockets) in your throat
  • Infected lymph nodes in your neck
  • Sinus infection
  • Rheumatic fever, which can cause damage to your heart, joints, nervous system and skin; it occurs mainly in children ages 5 to 15, and affects 1 to 3% of those with untreated strep throat
  • Strep infection of the skin, such as impetigo (more likely in the summer)
  • Scarlet fever, a bright red, rough, sandpaper-like rash that starts on the face and neck before spreading down the body; it can be caused by strep throat or strep skin infections
  • Toxic shock syndrome, a rare but potentially life-threatening condition caused by strep bacteria releasing toxins into your body

Some suggest strep throat also is linked to a rare condition that worsens neuropsychiatric conditions (such as obsessive-compulsive disorder or tic disorder) in children. The existence of this condition—dubbed "Pediatric Autoimmune Neuropsychiatric Disorder Associated with group A Streptococcal infections, or PANDAS— is debated in the medical community.

Can you get strep throat more than once?

Once you recover from strep throat, you aren't immune from future infections. You can get strep throat repeatedly.

Also, some people with strep have no symptoms, but can spread it to others. If you have recurring strep throat in your family, consider having people without symptoms who have regular contact with you tested as well, so you can find the infection's source. (One family in Madison, Wisconsin, determined their cat was the culprit.)

Other ways to prevent strep throat include the same measures being suggested to avoid contracting coronavirus. Strep bacteria are highly contagious and spread through droplets expelled into the air from coughing or sneezing, so maintain distance from others. You can also pick it up from surfaces and transfer it to your mouth, eyes or nose, so wash your hands often and avoid touching your face.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jun 22
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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