When 12 year-old Sam was admitted to the hospital, his case was initially baffling. His mother said that he just suddenly refused to eat then his feet, legs, abdomen and face started swelling. He also had difficulty urinating and the little urine he could excrete was tea-colored.
He was obviously having a kidney failure but doctors couldn't pinpoint the cause. He didn't have any preexisting health condition that might lead to a kidney problem such as diabetes, high blood pressure, or hormonal disorders. Before his condition, he was said to be "a very healthy boy".
Then her mother mentioned that he had a "mild" tonsillitis which he quickly recovered from two weeks ago adding that Sam discontinued taking his antibiotics when he felt he was getting better. That's when his doctors realized the culprit: Group A β-hemolytic streptococcus (GABHS), the bacteria behind a form of tonsillitis called strep throat.
Tonsillitis or the inflammation of the tonsils is such a common illness and one which is easy to cure that we hardly consider it a serious condition. However, if it is untreated or treated inadequately, it can lead to severe complications. In fact, even if it appears to be "cured" as in the case of Sam, a simple tonsillitis can become deadly.
Sam's ailment is called glomerulonephritis which is characterized by inflamed glomeruli, the part of the kidney which filters the waste from the bloodstream. How exactly did a throat ailment become a kidney problem? As mentioned, Strep throat is caused by GABHS bacteria.
When these organisms attacked Sam's tonsils, they triggered his immune response to produce antibodies which attached to them producing the so-called antigen-antibody complexes. These substances became lodged on the membrane of his glomeruli and caused inflammation. If the glomeruli are inflamed, their ability to remove waste from the blood is impaired thus developing a kidney disorder. That's why Sam's kidneys partially stopped working which further resulted to fluid electrolyte imbalance and fluid retention in his body - thus, his swelling.
Without quick and appropriate treatment, Sam's state could have led to fatal conditions such as end-stage renal disease (collapse of the kidneys), pulmonary edema (water-filled lungs), congestive heart failure, malignant hypertension, and sepsis (blood poisoning) among many others.
Heart Valve Destruction
The kidneys, however, are not the only unlikely body organs that bacterial tonsillitis can affect. Tonsillitis–causing streptococci or GABHS can also target the heart. In fact, GABHS is the pathogen behind Rheumatic Heart Disease. Streptococci sometimes have a substance called M-protein to which antibodies and other immune cells are very sensitive. In fact, if you have tonsillitis caused by GABHS, most of the immune cells and antibodies coming to your rescue were probably alerted by the M-proteins of the invading organisms. However, this M-protein has similarities with the molecular structure of the heart muscle fiber called myosin.
Thus, when antibodies sensitive to M-protein are triggered to attack the streptococcus in your throat, they mistake the myosin of the heart, specifically of its valves, as M-protein too. Hence, they also attack the myosin resulting to the destruction of your heart valves. If untreated, the damaged valves will fail to close and open properly leading to congestive heart failure and eventually death.
But as stated, tonsillitis need not lead to these conditions. If you've been diagnosed with strep throat, complete the dosage of antibiotics that was prescribed to you. Do not be tempted to stop even after you feel better like Sam. Most antibiotics should be taken in proper dosages within 5-7 days. If you fail to do so, the bacteria will just be weakened but not killed. It will stay in your body waiting to strike again and cause greater damage once your resistance fails.