RVA Parenting: Other Complications of Strep

“A real misnomer for parents is that strep needs to be treated because it'll make their child feel better,” says Dr. Jeff Bennett, D.O., FAAP of KidMed.In reality, strep is self-limited, and it's a disease that will go away untreated. But it's so important to treat -- not just because we want the kids to feel better, which we do. Also, they don't communicate the illness once they've been on antibiotics typically for about 24 hours. But by far, the most important reason why we're treating strep is to prevent what's called rheumatic fever.”

Rheumatic fever is not common in the United States, but the literature says about one to two percent of untreated strep patients can get rheumatic fever.

“The reason we're so worried about rheumatic fever is because they can get heart problems,” says Dr. Bennett. “You have about nine days from the time of symptoms and diagnosis to diagnose and treat and prevent rheumatic fever. It's important to treat to prevent the rheumatic fever.”

There are a lot of other complications of strep:

  • Strep can cause kidney problems called, glomerulonephritis. “So if your child is peeing blood three weeks after a strep infection, that's important to remember that they had strep,” says Dr. Bennett.
  • Heart problems, but it can also cause complications.
  • Peritonsillar abscess or a pocket of pus behind strep, so strep throat can be the beginning of a really bad infection in the throat, says Dr. Bennett.
  • It can also cause some weird things like the PANDAS is a lot is in the news, says Dr. Bennett. “There's some neuropsychiatric problems than can occur because of the strep bacteria.”

“Strep can cause a lot of different problems, and it's really important to treat it,” says Dr. Bennett. “Fortunately, we have some really good medications that we can usually eradicate it, but more importantly diagnosis because you cannot always tell just by looking at a throat.”

“I'm always shocked. ‘Wow, that kid had strep throat because it wasn't even terribly red. They just vomited once, and it turned out to be strep.’ It's really important to use our diagnostic tools. Most places use a quick strep test, and that captures about 90%, but can miss about 10% of the kids,” explains Dr. Bennett.

Dr. Bennett says they used to send off a culture, which took three to four days to come back which was frustrating for parents when their child had three to four days of fever, and the child would not be treated because their quick strep was negative. Then, the culture would come back positive a few days later.

“Now, we have a special test called a molecular strep test that we can get the results well within 24 hours, so within 24 hours we'll be able to confirm whether your child does or does not have strep,” says Dr. Bennett. “It's even more sensitive than the old culture, and it comes back way faster, and it's actually cheaper. It's a great test, and we've captured a lot of strep that the quick strep test missed, and we caught it within 24 hours. It's been real satisfying to us as clinicians, but also to parents.”

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