Can strep throat spread to your ears

Strep throat is a bacterial infection that can make your throat feel sore and scratchy. Strep throat accounts for only a small portion of sore throats.

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Strep throat infection
Strep throat infection
When to see a doctor
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Risk Factors
Can untreated strep cause ear infection?
Can a throat infection spread to your ear?

If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.

Strep throat is most common in children, but it affects people of all ages. If you or your child has signs or symptoms of strep throat, see your doctor for prompt testing and treatment.

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Symptoms

Strep throat infection Open pop-up dialog box

Strep throat infection

Strep throat usually causes throat pain and difficulty swallowing. This photo of strep throat shows inflammation and red spots, caused by the infection.

Signs and symptoms of strep throat can include:

Throat pain that usually comes on quickly
Painful swallowing
Red and swollen tonsils, sometimes with white patches or streaks of pus
Tiny red spots on the area at the back of the roof of the mouth (soft or hard palate)
Swollen, tender lymph nodes in your neck
Fever
Headache
Rash
Nausea or vomiting, especially in younger children
Body aches

It's possible for you or your child to have many of these signs and symptoms but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other illness. That's why your doctor generally tests specifically for strep throat.

It's also possible for you to be exposed to a person who carries strep but shows no symptoms.

When to see a doctor

Call your doctor if you or your child has any of these signs and symptoms:

A sore throat accompanied by tender, swollen lymph glands
A sore throat that lasts longer than 48 hours
A fever
A sore throat accompanied by a rash
Problems breathing or swallowing
If strep has been diagnosed, a lack of improvement after taking antibiotics for 48 hours

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CDC is looking into an increase in invasive group A strep (iGAS) infections among children in the United States. iGAS infections include necrotizing fasciitis and streptococcal toxic shock syndrome.

Strep throat is an infection of the throat and tonsils. It causes pain, redness, or pus in the back of the throat.

Sore Throat Due to Inflammation

Causes

Strep throat is caused by streptococcal (strep) bacteria. The strep bacteria is spread by airborne droplets. This occurs with coughing or sneezing from infected people, or by touching a contaminated surface and then touching your eyes, nose, or mouth. The droplets can also be inhaled.

Risk Factors

Strep throat is more common in children and adolescents. Other factors that increase your chance of strep throat include:

Exposure to family member or friend who has strep throat
Crowded living situations
Having strep living in the throat—occurs in a large segment of the population

Symptoms

Strep throat may cause:

Red, sore throat with white patches
Headache
Swollen, sore glands in the neck
Fever
Red spots on the roof of the mouth
Painful, difficult swallowing
Chills
Fatigue
Nausea and possibly vomiting
Decreased appetite
Rash
Muscle aches, especially in the neck, and abdominal pains, especially in younger children
Swelling in back of mouth

Complications of untreated strep throat can be serious and include:

Post-streptococcal glomerulonephritis (kidney damage) is also rare, but it can occur, even with treatment

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The doctor may assume strep throat based on symptoms. Tests may be done to confirm. Tests may include:

Rapid antigen strep screen—fast test that may not detect all strep throat.
Throat culture—A sample of throat fluid is taken to a lab. It takes a few days to gets results.
Rapid DNA test—results are usually available in 1 day. Can tell the difference between strep and other throat infections.

Treatment

Most sore throats, including strep throat, will get better in 7 to 10 days. Although the sore throat disappears, the infection may remain. It is important to follow through with proper treatment to prevent serious complications.

Medications

Antibiotics will be given to treat the infection. They may be given as a pill or a shot. Symptoms will often fade in the first few days of treatment. It is important to take all of the antibiotics as prescribed.

Over-the-counter pain relievers and fever reducers may also help.

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Prevention

To help reduce your chances of strep throat:

Wash your hands carefully and often.
Do not share beverages or food.
Avoid exposure to other people who may have a strep infection.
Replace your toothbrush after starting antibiotic treatment to prevent re-infecting yourself.

Resources

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

Canadian Resources

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

Health Canada
https://www.canada.ca

References

Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician. 2009;79(5):383-390.

Montagnani F, Stolzuoli L, et al. Erythromycin resistance in Streptococcus pyogenes and macrolide consumption in a central Italian region. Infection. 2009;37(4):353-357.

Sore throat. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/approach-to-the-patient-with-nasal-and-pharyngeal-symptoms/sore-throat. Accessed January 29, 2021.

Sore throats. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/sore-throats. Accessed January 29, 2021.

Streptococcal pharyngitis. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T115782/Streptococcal-pharyngitis. Accessed January 29, 2021.

Can untreated strep cause ear infection?

Complications of untreated strep throat can be serious and include: Middle ear infection or sinus infection.

Can a throat infection spread to your ear?

Sometimes, the bacteria from a throat infection can travel into the eustachian tubes and middle ear, causing an ear infection. Other symptoms of strep throat include: white patches or pus on the tonsils.