Streptococcal pharyngitis, as strep throat is formally known, causes these symptoms:
- fever (greater than 38°C or 100.4°F), chills, and sweating
- white patches on the tonsils
- sometimes nausea and vomiting
- sore throat
- swollen tonsils and lymph nodes in the neck
Coughing, runny nose, stuffiness, and sneezing aren’t associated with strep throat and are usually signs of a viral infection. It’s also rare for streptococcus to invade the larynx (voice box), causing hoarseness – this is far more likely with a virus. Of course, it’s possible to have both viral and bacterial infections at the same time.
It takes about 24 to 72 hours for the bacteria to incubate in the body, or become great enough in number before symptoms are seen.
Before the discovery of antibiotics, strep throat often led to serious complications. The most dangerous of these was rheumatic fever. In rheumatic fever, the immune system inflicts serious damage on the vital heart valves. This can leave a person vulnerable to heart disease later in life. Fortunately, this is a very rare occurrence today.
Other possible complications include immune overreaction in the joints (arthritis) or in the kidneys (glomerulonephritis). The bacteria can also travel up tubes that link the throat to the middle ears (the eustachian tubes). This is especially likely in young children, whose ear tubes aren’t yet fully developed. This causes otitis media, which is an infection of the middle ear. The bacteria may also get into the lining of the brain and cause meningitis.
All of these complications are extremely rare, except otitis media. A few children develop a chronic pattern of recurring throat and ear infections.
The syndrome known as scarlet fever is a fairly rare, usually mild complication of strep throat, and is essentially a strep throat accompanied by a temporary red rash. The rash is most prominent on the abdomen and the sides of the chest. Some skin may peel when it subsides.
If complications do appear, they often come 1 to 6 weeks after the strep throat infection. Call a doctor if you see any of these symptoms:
- joint pain
- severe abdominal pain
- stiff neck
- sudden high fever
- red rash
- stomach pain