What Could Go Wrong With Strep?


Many parents worry about Strep throat infections in their children. As a pediatric practice, we are often swabbing children for a rapid strep test and strep throat culture. The reasons are not far-fetched and any worried parent is indeed justified to be. The reason is that this infection can lead to some very serious complications, especially in children. According to the CDC, each year between 1,100 and 1,600 people die due to invasive group A strep disease. Strep throat is not invasive and its complications are rare however, we need to be aware of them as the consequences of these complications can be severe.

Streptococcal pharyngitis is an infection that can cause by a bacteria called Streptococcus pyogenes, also called Group A Streptococcus. It is an infection through transmission in several ways since it is highly contagious.

Modes of Infection Transmission:

  1. Coughing
  2. Sneezing
  3. Shared food utensils
  4. Shared drink


Symptoms of Strep:

The symptoms of Strep Throat include common sore throat symptoms however unlike viral sore throats, strep sore throat does need treatment. Some of the symptoms include

  1. A sore throat that starts abruptly with painful swallowing
  2. Swollen lymph nodes in the neck
  3. Visible exudates on the posterior throat or pharynx
  4. Red spots on roof of mouth
  5. Fever
  6. Skin rash
  7. History of someone close who has been diagnosed with strep throat, usually a family member
  8. Headache
  9. Body aches
  10. Nausea, vomiting in the young

As you can see many of these symptoms are seen in viral sore throats too and so if the condition could lead to complications, it would be important to know whether it is viral or bacterial. Both adults and children can be susceptible to strep throat infection however complications are generally more common in adults. On the other hand, children are more likely to get infected because they spend more time playing with a wider number of children/people than the average adult. Children in daycare centers are usually in much closer proximity to each other.


There are two types of complications that can occur from Strep throat infection. One is with the infection itself progressing beyond the throat into nearby tissues:

  1. Otitis media (middle ear infection)
  2. Peritonsillar abscess (pus collecting around the tonsils with some pressure or inflammation effects on the nerves and tissues)
  3. Toxic shock syndrome
  4. Sinusitis
  5. Retropharyngeal abscess (pus collection in the space within the neck behind the pharynx)
  6. Lymphadenitis (infection of the lymph nodes)

These complications, on the other hand, are related to how the body responds to the infection and not the effects of the infectious agents themselves:

  1. Scarlet fever (a streptococcal infection characterized by a prominent rash)
  2. Glomerulonephritis which is inflammation of the kidneys that can lead to chronic kidney disease.
  3. P.A.N.D.A.S. – Pediatric Autoimmune Neuro Disorders Associated with Streptococcal Infections
  4. Rheumatic fever (a serious inflammatory condition that can affect the heart, joints, nervous system and skin)

These complications are all very serious and could be life-threatening. The non-infectious ones where the body’s immune system is reacting abnormally can lead to chronic illness and have severe life-long health problems. These are concerning for anyone and more so in children who have much more time to live, all things being otherwise equal.

What To Do:

When in doubt, make that call and see your doctor. It does not matter whether your think it is Strep or not, it is safer to have the child diagnosed than to assume it is (or is not) strep.

  1. Ensure that your child is drinking enough and remains well hydrated
  2. Give some antipyretic (ibuprofen) as this will help with pain and the fever
  3. Get to a clinic that offers rapid testing for strep via throat swab
  4. If the clinic is unavailable then you need to get to a clinic that has late after-hours pediatric services like Omega Pediatrics in Roswell Georgia.
  5. If you are far away from us, you may go to an urgent care clinic where your child can undergo test and treatment if positive.
  6. Sometimes the provider may not offer antibiotics if there is a high likelihood that this is a viral illness.
  7. Usually, the antibiotics are oral but sometimes a parent may opt for parenteral (injection) antibiotics.

What Could Go Wrong With Strep?

For the clinical symptoms, there is a scoring system that was developed and published in 1998 to help reduce the overuse of antibiotics . I have created a form here

Read a more detailed article here on the AAFP website.

What has been your experience with strep throat? Comment below or on our Facebook Page. Share this article.

Omega Pediatrics Difference: At Omega Pediatrics in Roswell, Georgia we understand the challenges that parents face when their children develop symptoms late in the day or after hours. Many pediatric offices are closed after 4 pm however we are open every weekday up to 9 pm for walk-ins and we have telemedicine via evisits for our known patients. Our clinic is one of the easily accessible pediatric primary care clinics in Roswell and Alpharetta. We provide pediatric primary care services to families in the North Fulton area We also serve families that live in the cities of Sandy Springs, Johns Creek, Duluth and Cumming.

Immunizations after-hours: One reason for switching to Omega Pediatrics for your child’s primary care is that you can bring your child in for immunization and other preventive health services after regular business hours. We provide this service because we have the passion for what we do and we want are committed to providing accessible and convenient service beyond what one would expect from the ordinary pediatric doctor’s office.

Book an appointment online here.

Image Credits: Dave Matos Flickr

Image Credits: Pixabay

Scroll to Top