How long before Strep causes heart damage?

Question

I have always heard of the danger of strep causing heart valve and kidney damage and all sorts of terrible complications, but I have never seen in writing how long someone has to let strep go untreated before this damage occurs. My child has what I beleive is strep but the hospital advice nurse suggested not bringing him in for a couple of days to see if he gets better, he is better (no fever and his throat doesn't hurt much) but he now has hives over his back and neck, and now it's the weekend so the family medicine clinic isn't open. I often wonder how our ancestors dealt with common problems like this in the days before running to the emergency room for a case of sniffles. Also, does strep ever resolve itself?

Answer 1

I believe the heart disease and the kidney damage that you are talking about are termed as rheumatic fever and glomerulonephritis, respectively.

Here's the deal with both diseases--the two of them are ONLY SEQUELA of having been infected with Streptococcus organisms, more implicated is Streptococcus pyogenes. As sequela, it means that the bacterium is NOT the direct cause of the disease, rather the infection itself. Rheumatic fever is a complication of the strep infection that is considered as an autoimmune-related disease, wherein the bacterium produces antigenic proteins that mimic protein sequences similar to the endocardium, or the heart. Our immune system sees this as "non-self" and, as what it is designed to do, attack the antigens...what results is a cross-reaction, because our antibodies cross react with the porteins in our heart, causing valvular damage--the hallmark of rheumatic fever.

Glomerulonephritis, on the other hand, is a complication resulting from the battle of your immune system with the bacterium that caused the infection. This is where dead cells such as the bacteria, leukocytes, and immuno-precipitates clog the vessels of the kidneys (mainly in the glomerulus), causing it to block fluid flow and promote inflammation.

Now, these two sequela could or could not occur, depending on a number of factors, such as immune clearance and the ability of the immune system to combat the infection effectively. Your child seems to be recovering from the infection, and no sequela seems to be manifesting, so he'll continue to recover like any other healthy kid. The hives may have been caused by a particular allergen, such as the antibiotics he may have taken or something he might have eaten that triggered the allergic reaction.

Usually, dealing with strep (in the form of pharyngitis) is analogous to letting the sick person take lots of rest and take medicine for the symptom/s only, and resolution often is observed since our immune system has the capacity to deal with the infection. Only in some rather extreme instances, such as scarlet fever (also S. pyogenes), cellulitis, or necrotizing fasciitis (the "flesh-eating" disease), do people bring the patient to the hospital for a routine battery of medication.

Except for the allergic reaction, your kid is fine and should recover from the infection; if ever you get the chance, I recommend you to consult an Allergist for his hives for any further meds your child may need.

Hope this helps!

Answer 2

If he's suddenly broken out in hives, take him to the emergency room. Jeeez. They can also do a strep test. But he needs to be seen right away. Come on, mom.......think.

Answer 3

bring him to the emergency room. I wouldn't let it wait, especially hives. our ancesters died of infection before anitbiotics came around.