From the Guidelines
Complications of strep throat typically manifest within 1-3 weeks after the initial infection if left untreated, with early complications like peritonsillar abscess developing within days and post-streptococcal complications like rheumatic fever appearing 2-3 weeks after infection 1.
Key Complications and Their Timing
- Peritonsillar abscess (quinsy) can develop within days, presenting with severe throat pain, difficulty swallowing, and voice changes.
- Post-streptococcal complications like rheumatic fever usually appear 2-3 weeks after infection.
- Post-streptococcal glomerulonephritis typically develops 1-2 weeks after a throat infection.
- Scarlet fever rash may appear within 1-2 days of strep throat symptoms.
Prevention of Complications
To prevent these complications, prompt treatment with antibiotics is recommended. The choice of antibiotic should be based on the patient's allergy history and the severity of the infection.
- For non-allergic patients, penicillin V (500 mg twice daily for 10 days) or amoxicillin (500 mg twice daily for 10 days) is recommended 1.
- For penicillin-allergic patients, alternatives include azithromycin (500 mg on day 1, then 250 mg daily for 4 days) or clindamycin (300 mg three times daily for 10 days) 1.
Importance of Completing Antibiotic Course
Completing the full antibiotic course is crucial even if symptoms improve, as this prevents complications by eliminating the Group A Streptococcus bacteria before they can trigger the immune-mediated responses that lead to serious sequelae 1.
From the Research
Complications of Strep Throat
- The complications of strep throat can manifest at various times, depending on the specific complication 2, 3, 4, 5, 6.
Timing of Complications
- Acute rheumatic fever (ARF) typically occurs 2 to 3 weeks after a group A streptococcal infection 3, 5, 6.
- Post-streptococcal glomerulonephritis (PSGN) usually occurs 1 to 3 weeks after a group A streptococcal infection 2, 4.
- Post-streptococcal reactive arthritis (PSRA) tends to occur within 10 days of a group A streptococcal infection 5, 6.
Factors Influencing Complication Onset
- The onset of complications can be influenced by factors such as the strain of the bacteria, the individual's immune response, and the presence of underlying health conditions 2, 3, 4, 5, 6.