Complications from the infection can be life-threatening.
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When is a sore throat a sign of something more? Roughly 10 million Americans contract mild strep infections each year and antibiotics typically nip the problem in the bud, but if left untreated, those same infections can progress to more serious conditions. Last December, 24 hours after first complaining of strep throat symptoms, Kevin Breen, a 44-year-old husband and father of three, was admitted to the hospital with acute pancreatitis. During an exploratory procedure, doctors found 1.5 liters of infected pus teeming with streptococcal bacteria in Breen's stomach. He lived, but the medication that saved him ultimately caused kidney failure and tissue death in his extremities—he's now a candidate for partial amputation surgeries in both hands and feet. Here's what you need to know about the potentially fatal infection.
1. STREP BACTERIA THRIVES IN YOUR NOSE AND ON YOUR SKIN.
"The bacteria Streptococcus pyogenes (or group A strep) lives exclusively on human skin and mucus membranes," says James Wantuck, M.D., of leading online urgent care provider PlushCare. "Contact with people who have it is the only way to get it." Strep throat is most common in children ages five to 15 years old; likewise, parents of children in that age range contract strep more often than others.
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2. STREP IS HARDER TO SPOT IN CHILDREN UNDER 3.
The younger the patient is, the less typical their symptoms are, says Dr. Wantuck. Children under three may have vague complaints of abdominal pain and fatigue, and may refuse to eat, for example. It's possible to have a strep infection without a sore throat, and very young children "might not complain [like] someone who's more able to articulate their symptoms."
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3. THE SYMPTOMS YOU DON'T HAVE ARE JUST AS TELLING AS THE ONES YOU DO.
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"Oftentimes a sore throat will accompany a common cold, but the other symptoms of a cold —runny nose, cough, congestion—are not typical for strep. That's a good layman's way to distinguish between the two," says Wantuck. Other common strep symptoms include swollen lymph nodes and glands in the neck and a rash.
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4. THE LONGER THE INFECTION LINGERS, THE MORE LIKELY IT IS TO TURN INTO SOMETHING SERIOUS.
"A sore throat that doesn't go away after three to five days should be evaluated by a doctor," says Wantuck. Likewise, if you've been treated and the sore throat doesn't improve with medicine in three to five days, it's time to go back to the doctor.
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5. SOME PEOPLE ARE CARRIERS OF STREP.
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If your child is getting recurrent infections, either in the same year or throughout childhood, they may be a carrier—someone without symptoms who tests positive for strep throat, according to the CDC. "We can test [carriers] for strep when they're sick and when they're not and it will be positive regardless," says Wantuck. "Antibiotics don't completely eliminate it from these children."
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6. STREP COMPLICATIONS CAN BE DEADLY.
Strep throat that goes untreated can progress to more serious conditions like:
The latter three can be fatal. Last March, a six-year-old Ohio girl lost her leg after flesh-eating bacteria entered her bloodstream—the result of an earlier strep throat infection—and began attacking the tissue, nerves, fat, and blood vessels in her body.
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7. OTHER BACTERIAL INFECTIONS CAN MASQUERADE AS STREP.
"Just because you test negative for strep doesn't mean that you don't have a bacterial infection," says Dr. Wantuck. "If your throat is sore for five days or more and you're not getting better, you need to see a doctor. It's probably not just a virus and it's not going to go away on its own."
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8. IF YOU SUSPECT IT'S STREP, STAY HOME.
Washing your hands and not being around people who have strep throat is the best way to prevent getting sick. "If you have it, you shouldn't be going to school or work until you're treated," says Dr. Wantuck. As a general rule, strep patients who've been on the correct antibiotics for at least 24 hours, and no longer have fever, are safe to go out in public.
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