Strep Throat Complications

2 Types of Long-Term Complications

Boy being examined by a doctor for a sore throat.
Boy being examined by a doctor for a sore throat. ADAM GAULT/SPL/Getty Images

It is sometimes difficult to differentiate strep throat from a sore throat caused by a virus or another condition. However, there are some dangerous strep throat symptoms and complications that make it important for you to visit your doctor if you think you might have strep throat. Furthermore, if you do test positive for strep throat you need to be treated with an appropriate antibiotic to avoid potentially developing these dangerous complications.

Symptoms of Strep Throat

Strep throat can cause a range of symptoms, from simple nuisances to more serious, long-term health problems. Acute (immediate) symptoms of strep throat can last anywhere from 12 hours to 5 days after you have been exposed to the Streptococcus bacteria. It is important to treat your strep throat by visiting your physician, getting a strep test, and (if necessary) taking an antibiotic to prevent longer-term complications.

Common symptoms of strep throat:

Symptoms that require immediate medical attention:

  • difficulty swallowing
  • difficulty breathing
  • continuous drooling
  • lips that are a blue or grey color

While not common, if you experience any of the 4 life-threatening symptoms listed above, it is important that you seek immediate medical assistance (by calling 911 or going to your nearest emergency room).

Delaying medical help could result in death.

Long-Term Complications Of Untreated Step Throat

While you need to be aware of the symptoms listed above, the symptoms will go away with treatment. However without appropriate treatment for strep throat, you should understand the long-term consequences. When strep throat is not treated with antibiotics it can sometimes seem that your immune system has beaten the illness on its own.

This means that you feel much better and start going back to work or school etc. This is the time when serious problems can occur. These complications can be divided into 2 main categories: suppurative (pus-forming) and non-suppurative (non-pus-forming).

Pus-Forming (Suppurative) Complications of Untreated Strep Throat

The 3 most common pus-forming complications that can occur from untreated strep throat include:

Other less common complications that result from the formation of pus include infections that spread to the blood, spinal cord, brain, and muscle sheaths. These complications can also be life-threatening if not treated appropriately.

Non-Pus-Forming (Non-Suppurative) Complications of Untreated Strep Throat

The most commonly thought of complication of untreated strep throat is is rheumatic fever. however there are other possible complications:

Rheumatic fever and kidney inflammation are thought to be caused by a strange phenomenon in which the strep bacteria cause your immune system to behave erratically and attack your own organs.

Scarlet fever is caused by an erythrotoxin produced by the bacteria. This is why it is so important to treat the streptococcus bacteria with antibiotics until it is completely destroyed. The following symptoms after a bout with strep throat could be warning signs: changes in the color or amount of your urine, severe joint pain, high fever, rash, seizures or other neurological changes.

Determining the Difference Between Strep Throat and the Cold Virus

Figuring out which of these two illnesses is the cause of your sore throat without having a throat culture is not always possible. However, there are some key differences.

Strep throat usually involves a severe sore throat that is usually not accompanied by a runny nose, coughing, congestion and sneezing. However, the only way to know for sure if you have strep is to visit your doctor and have a rapid strep test or throat culture performed.

Dangerous strep complications often occur in children who get strep throat without the knowledge of their parents, particularly if the case of illness is mild. A parent may not know that a child is sick, or may mistake strep for a mild cold. If you notice a loss in appetite, difficulty swallowing or a fever in your child, it's important that you take him or her to the doctor.


Intermountain Healthcare. Let’s Talk About… Strep throat. Accessed: September 7, 2009 from

Medline Plus. Strep Throat. Accessed: September 7, 2009 from

Pichichero, M.E. (2016). Complications of streptococcal tonsillopharyngitis. Accessed on June 26, 2016 from (Subscription Required)