Understanding Recurring Strep Throat in Adults: Causes, Symptoms, and Treatment

Recurring strep throat in adults is often caused by weakened immunity, antibiotic resistance, or repeated exposure to bacteria. This persistent bacterial infection requires antibiotics for treatment to avoid complications. Common symptoms include a sore throat, fever, and swollen lymph nodes, lasting more than a few days. Treatment typically involves antibiotics, but preventive strategies can help reduce the frequency of infections. In severe cases, surgery may be recommended to treat tonsilitis.

A bout of strep throat is anything but comfortable. Your throat is burning, your temperature is up, your neck feels swollen, and everything – from swallowing to talking – feels irritating. It’s frustrating to then recover, only to be hit with the same symptoms again and again.

If left untreated, symptoms of recurring strep throat can last multiple weeks, and you remain contagious throughout this time. Taking antibiotics helps speed up recovery, killing the offending bacteria and improving symptoms in as little as two days. A full ten-day regimen is usually enough to get rid of the bacteria entirely. But in some cases, a strep throat infection can recur.

Understanding why strep throat can be recurring – and knowing what to do about it – can break a vicious cycle of discomfort, pain, and potentially even surgical intervention (tonsillectomy).

What is Strep Throat and Why Does Streptococcus Bacteria Recur in Adults?

Strep throat and a regular sore throat are two different issues. Strep throat is caused by streptococcus bacteria called Streptococcus pyogenes. Kids are more prone to strep throat infections, but they can affect adults as well. Furthermore, S. pyogenes is one of a rare few bacteria that only infects humans, and transmission from an animal or animal-based product to humans is very unlikely.

Streptococcal pharyngitis is the formal name for strep throat. This means that nearly all cases of strep throat are caused by exposure to an infected person, usually through the inhalation of their respiratory droplets. This doesn’t have to be caused by a cough or sneeze – talking indoors can also be a vector for transmission. This is also why strep throat is more common during the colder months, as people are more likely to crowd indoors during social gatherings.

Adults are more likely to develop strep throat if they’re frequently exposed to infected people – including kids – and are more likely to develop a persistent or recurring strep throat if their immune system is compromised, if the bacteria is antibiotic-resistant, or if they do not go through the entirety of the antibiotic treatment regimen. Even after treatment, about one in ten treated kids remains positive for strep and can continue to be an active carrier without acute symptoms. A strep carrier can test positive for strep even when experiencing a viral infection, leading to confusion in diagnosis and treatment.

Common Causes of Recurring Strep Throat in Adults

A stronger immune system can help prevent a strep throat infection and help lower the risk of recurrent infections. Many people struggle with hereditary autoimmune deficiencies or chronic illnesses. These can make recurring strep throat more common.

Too much stress, both physical and psychological, can also burden the immune system. There’s a reason people tend to get sick much more easily when they’ve got too much on their shoulders, and taking a break – or finding a healthy way to cope with the pressure – can greatly improve the immune system.

Other lifestyle factors can also weaken the immune system, particularly substance use, poor hygiene, and lack of consistent sleep.

Finally, recurring exposure can increase the risk of infection. Individuals who tend to work around sick children are at greater risk for a strep throat infection and need to take greater precautions against the bacteria, such as masking, and frequent testing to combat early infection. Preventing strep throat through good hygiene practices and lifestyle choices is crucial in reducing the risk of infections.

Symptoms of Recurring Strep Throat: What to Watch For

Strep throat causes

• sore throat
• fever (over 100 degrees)
• enlarged lymph nodes around the neck
• white or yellow spots on the tonsils (pus)
• swollen tonsils

As the infection progresses, it can also cause:

• muscle pain and soreness
• headaches
• nausea
• vomiting

Among adults, about 5 to 15 percent of sore throats are caused by strep throat.

The easiest way to differentiate a normal sore throat from a strep throat is to try and get a look at your tonsils, through a mirror or picture. If your sore throat is coupled with an increased temperature, it’s a good idea to call your doctor and get a rapid test going to confirm the diagnosis. The earlier strep throat is diagnosed, the earlier it can be addressed, and the lower the chances of a recurring infection. A rapid strep test is crucial for quick diagnosis and treatment, allowing patients to receive necessary prescriptions without prolonged waiting times.

While further complications are rare, they become a greater risk when a strep infection becomes recurrent. Recurring bacterial infections can be a burden on your body, leading to an antibody deficiency (reducing your body’s ability to fight future infections), and affecting your heart and kidneys. In pregnant women, strep infections can sometimes cause sepsis.

When Should You See a Doctor for Recurring Strep Throat?

Ideally, any instance of strep throat warrants a visit to the doctor’s office. A throat culture can confirm the presence of Streptococcus bacteria, especially when rapid tests are inconclusive. Antibiotic treatment can take care of the most severe symptoms in just a few days, and a full regimen helps kill the chance of a recurring infection. If your symptoms are mild, your doctor may recommend taking a few over-the-counter painkillers or cough medicine and waiting for the infection to subside. If you are at greater risk of reinfection or have experienced recurring bouts of strep, then antibiotics are the first-line treatment.

Treatment Options for Adults with Recurring Strep Throat

If you have been experiencing recurring strep throat infections for some time, then your doctor may want to put you on a specialized antibiotic treatment plan targeting strep bacteria, and couple it with other precautions to further reduce your chance of reinfection, such as avoiding other infected people (especially children), improving your oral health and hygiene, and improving your immune health through diet, nutritional supplements, and lifestyle recommendations such as sleep and exercise.

Antibiotics are currently the only effective way to treat strep throat directly. Like most bacteria, there are types of antibiotic-resistant strep throat out in the wild. These superbugs can be treated with other modern antibiotics, but it is becoming a biological arms race. Untreated strep throat can lead to further episodes and increase the risk of subsequent infections. Doctors will usually avoid prescribing antibiotics if symptoms are mild, and the patient is otherwise healthy. If they are at greater risk of developing recurring strep infections, rheumatic fever, or other complications, then antibiotics can greatly shorten the duration of the illness and avoid complications.

Penicillin V is the first choice for strep throat in the US, but penicillin-sensitive or allergic patients can be prescribed other antibiotics instead. Symptoms persisting despite antibiotic treatment may indicate a viral infection.

Conclusion

Recurring strep throat can cause serious complications, including other bacterial infections, or a weakened immune system. An individualized antibiotic treatment coupled with lifestyle changes meant to bolster your body’s immunity can help break the cycle and avoid further health problems. It’s important to get regular check-ups afterward and keep an eye out for recurring symptoms.