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Symptoms and Signs of Strep Throat

Doctor's Notes on Strep Throat Symptoms, Causes, Remedies, and Antibiotic Treatment

Strep throat is actually a slang term for an infection caused by group A Streptococcus bacteria that results in a sore, inflamed throat. While strep throat is a common ailment, the majority of cases of sore throat are caused by viruses and not Streptococcus infections. Strep throat is very contagious and is spread by person-to-person contact with an infected individual.

The most common symptoms of strep throat are a painful, sore throat, headache, fever, and an upset stomach. Infants and young children may also exhibit fussiness, enlarged lymph nodes (“swollen glands”), poor appetite, and a thick nasal discharge. Associated symptoms can include redness of the back of the throat and tonsils, white or yellow spots on the tonsils, small red punctate (“dots”) areas on the roof of the mouth, and a rash over the torso and groin areas.

Medical Author:
Medically Reviewed on 3/11/2019

Strep Throat Symptoms, Causes, Remedies, and Antibiotic Treatment Symptoms

In general, treatment at home consists of measures to control the pain and associated symptoms of strep throat. The vast majority of cases of strep throat can be managed at home, unless rare serious complications develop. Various home remedies and over-the-counter medications are useful in relieving the symptoms of strep throat.

Drink plenty of fluids to avoid dehydration. Because fever can increase fluid loss and painful swallowing can decrease fluid intake, measures must be taken to avoid dehydration. Choose high-quality fluids such as warm soup broth (which replaces both salt and water loss) and sugar-containing solutions (they help the body absorb the fluids more rapidly). Avoid caffeine because it can cause water loss. Sometimes cold beverages, Popsicles, and ice cream can be soothing and beneficial.

Throat lozenges can sometimes provide temporary relief for a minor sore throat. Various formulations exist, though they are not recommended for young children, due to the possibility of the child aspirating the small lozenge. Gargling with salt water is also sometimes helpful; people may try mixing table salt (about 1 to 2 teaspoons) with warm water (about 8 oz) and gargling.

Over-the-counter (OTC) pain medications. OTC pain medications such as acetaminophen (Tylenol) and ibuprofen (Motrin or Advil) can be effective for reducing fever and providing pain control. Adequate pain control can also help with increasing fluid intake.

Get extra sleep. Adequate rest and sleep can promote a more rapid recovery.

Herbal teas. Herbal teas containing ingredients such as licorice may also provide significant pain relief.

In those individuals who develop strep throat, the symptoms usually begin between 1 to 4 days after initially acquiring the infection (incubation period). The symptoms can range from mild to severe. The sore throat associated with strep throat is usually described as starting rather suddenly, and the tonsils and the back of the throat may appear red and swollen. Swallowing is usually painful, and thus some individuals may have varying degrees of dehydration due to lack of adequate fluid intake.

Often times, however, it can be difficult for healthcare professionals to diagnose strep throat based on symptoms alone, as strep throat and a sore throat due to a viral infection can often have similar overlapping symptoms. However, the presence and absence of certain symptoms can make strep throat more likely.

In general, the common signs and symptoms of strep throat include the following:

  • Fever
  • Sore throat
  • Red and swollen/inflamed tonsillitis)
  • Swollen and tender lymph nodes on the sides of the upper neck (cervical lymphadenopathy)
  • White patches or spots on the tonsils (tonsillar exudate)

Individuals with strep throat can experience other associated signs and symptoms as well, which may include any of the following:

  • Headache
  • Abdominal pain
  • Nausea and vomiting
  • General discomfort, feeling ill or uneasy
  • Loss of appetite
  • Small punctate red spots on the soft or hard palate (the roof of the mouth)
  • Skin rash (scarlet fever)

Although the presence of runny nose, cough, hoarseness, eye redness, muscle aches, ulcers in the mouth, and diarrhea make a viral infection more likely, the possibility of strep throat must still be considered by the health care professional. As previously mentioned, strep throat is most common between 5 to 15 years of age, though it can affect individuals of almost any age. Consequently, strep throat can sometimes manifest differently depending on the age of the affected individual, and special considerations must therefore be taken into account.

  • Strep throat in infants: Strep throat in this age group is uncommon. Infants may feed less and appear irritable and fussy. A low-grade fever and nasal discharge may be present as well.
  • Strep throat in children: Children will often complain of sore throat and painful swallowing. They also may eat less and complain of abdominal pain.
  • Strep throat in older children and teenagers: Strep throat in this age group can be extremely uncomfortable, with individuals often complaining of a severe sore throat. The fever can be high and they may be ill-appearing.
  • Strep throat in adults: Typically adults have milder symptoms and they may complain only of a mild sore throat. However, more severe symptoms are still possible in adults.

Occasionally, some people develop bad breath (stinky tonsils) when tonsilloliths (whitish deposits on and in tonsils) develop. These deposits are often dislodged when the patient coughs, but in some individuals food particles get trapped and bacteria attack the food particles and produce the bad odor. Removal of these deposits may be done by a qualified healthcare professional.

Strep Throat Symptoms, Causes, Remedies, and Antibiotic Treatment Causes

Strep throat is caused by infection with Group A Streptococcus (GAS) bacteria, specifically Streptococcus pyogenes. The streptococcal infection invades the pharyngeal tissue and causes a localized inflammatory reaction of the throat and tonsils. These bacterial organisms are often found in the throat or on the skin, and are responsible for other illnesses as well, such as impetigo (a skin infection). Some individuals may carry Group A Streptococcus in the throat or on the skin and not exhibit any signs or symptoms of disease (asymptomatic).

Strep throat is most common in school-aged children and teens, with a peak incidence between 5 to 15 years of age. It is estimated that approximately 15% to 40% of cases of sore throat in this age group are caused by Streptococcus spp bacteria. Adults may also develop strep throat, though less commonly (accounts for approximately 5% to 10% of cases of sore throat). Strep throat most commonly occurs between late fall and early spring. It is more widespread during the school year when groups of students are present within an enclosed space.

Though strep throat is the most common bacterial cause of sore throat, it is important to note that most cases of sore throat are in fact due to a viral infection (caused by a virus). A viral sore throat typically improves on its own and neither requires nor responds to treatment with antibiotics. However, the identification of strep throat is important to prevent the potential complications associated with this illness.

Sore Throat or Strep Throat? How to Tell the Difference Slideshow

Sore Throat or Strep Throat? How to Tell the Difference Slideshow

Your throat aches and burns. It’s painful to swallow. You know something is wrong, but how bad is it? Will it get better without antibiotics? Or will you need to visit the doctor?

This article is designed to help you find relief from your sore throat, and discover whether or not you likely have strep throat symptoms. You will find the telltale signs of strep throat and the common sore throat, as well as treatment options for both.

What Is Strep Throat?

Unlike the common sore throat, strep throat is caused by a bacterial infection. A Streptococcus bacteria (called "group A strep") infects the throat and the tonsils, and it will quickly respond to antibiotics. It’s important to distinguish strep throat from sore throat because treatment for both is very different.

What Is the Common Sore Throat?

A sore throat can be quite painful, but it is not as painful as strep throat. Unlike strep throat, the common sore throat is usually caused by a virus. This means it will not respond to antibiotics.

Even if it’s not strep throat, you may need to see a doctor for sore throat relief. It’s time to see the doctor if your sore throat

  • lasts longer than a week,
  • keeps coming back,
  • makes your voice hoarse for more than two weeks,
  • causes dehydration, or
  • worries you in some other way.

Read along to find what symptoms distinguish a common sore throat from strep throat.

Strep (Streptococcal) Throat Infection : Test Your Infectious Disease IQ Quiz

Strep Throat Quiz

Just about any painful sore throat is caused by strep.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.