Strep throat, a bacterial infection of the throat and tonsils caused by Streptococcus pyogenes, is common in children aged 5 to 15. Symptoms include a sore throat, red and swollen tonsils, white pus or red spots on the palate (petechiae), and sometimes a red rash all over the body, known as scarlet fever.

Doctor Nguyen Huu Hieu from the Pediatrics Department of Tam Anh General Hospital in Hanoi highlights potential complications of strep throat in children.

One possible complication is rheumatic fever, which typically appears two to four weeks after a strep throat infection. It's an abnormal immune response where the body attacks its own joints, heart, brain, and skin. Symptoms include migratory joint pain and swelling, fever, fatigue, rapid heartbeat, and shortness of breath. The most serious consequence is permanent heart valve damage, leading to rheumatic heart disease.

Another potential complication is acute glomerulonephritis, which usually occurs one to three weeks after strep throat. This is an immune response that causes inflammation in the glomeruli (filtering units of the kidneys). This inflammation reduces the kidneys' ability to filter blood, leading to decreased urine output, red or dark brown urine (due to blood), facial and limb swelling, and high blood pressure. Some cases may be mild and resolve on their own, but severe cases, if not detected and treated promptly, can lead to acute kidney failure or chronic kidney disease.

Doctor Hieu examining a young patient. Photo: Tam Anh General Hospital

Doctor Hieu examining a young patient. Photo: Tam Anh General Hospital

Sepsis is a severe, body-wide infection that occurs when the immune system overreacts to an infection (bacterial, viral, fungal, or parasitic), leading to organ dysfunction and failure. If not detected and treated promptly, it can rapidly progress and become life-threatening.

A peritonsillar abscess is an early complication that can occur during a strep throat infection. Bacteria from the throat and tonsils spread to the surrounding tissues, causing a pus collection. Symptoms include severe one-sided throat pain, painful swallowing, difficulty opening the mouth, a muffled voice, choking, persistent high fever, and fatigue. This is an ENT emergency requiring immediate medical attention.

Doctor Hieu emphasizes that sepsis is the most dangerous complication of strep throat. It occurs when streptococcal bacteria spread through the bloodstream to other organs, causing multiple organ failure and potentially death. These complications are more common in young children, the elderly, and those with weakened immune systems. Complications of strep throat can occur during the acute phase and for several weeks after the initial illness subsides. Early recognition, appropriate treatment, and close monitoring are crucial for effective disease management.

Doctor Hieu advises parents to seek medical attention immediately if their child shows signs of strep throat, such as high fever, sore throat, and red, swollen tonsils. Children diagnosed with strep throat must adhere to the doctor's instructions, complete the full course of antibiotics (usually 10 days), and not stop the medication even if symptoms improve. Children should maintain good personal hygiene, cover their mouths when coughing or sneezing, and limit close contact with sick individuals. Prompt medical evaluation is necessary if the child experiences persistent high fever, severe one-sided throat pain, difficulty breathing or swallowing, joint pain and swelling, decreased or bloody urine, facial swelling, chest pain, shortness of breath, or an abnormally rapid heartbeat.

Hang Tran