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A variety of things — including overuse, a common cold, a serious virus, or allergies – can cause a sore throat. Another culprit, especially in children and young adults, is the bacteria that creates strep throat. Streptococcus pyogenes (group A Streptococcus) is the formal name of the bacterium.

But how can you tell if it’s strep and not something else?

What Are the Common Symptoms?

When you have strep, you’ll usually find that your throat is quite raw and it really hurts to swallow. You’ll find that it comes on very fast, not gradually like many other kinds of sore throats. Other symptoms often include:

  • A fever of 101 F or higher
  • Swollen lymph nodes on your neck
  • Really little red spots on the back part of the roof of your mouth
  • Red and swollen tonsils (two round lumps in the back of your throat; they are types of lymph nodes). You may also see white patches on them or elsewhere in your throat.
  • Headache, sometimes with pain in the gut or vomiting.

You might also see a red, sandpaper-like rash that starts in the face and neck area and then spreads to the rest of the body. This could be a sign of scarlet fever. You should call your doctor if you or a child in your care show any symptoms of strep or you see this rash.

What Strep Throat Isn’t

It’s easy to confuse it with other conditions, so it helps to know what it’s not:

  • It’s not a virus — viruses can’t be cured with antibiotics.
  • It usually doesn’t come with a runny nose, a cough, or red eyes. These are usually signs of a virus or allergy.
  • It’s not life-threatening. But if you leave it untreated, strep throat can lead to more serious complications in some cases.

It’s Easily Spread

The bacteria that cause strep are highly contagious. You can spread it by close contact — including sneezes and handshakes — or sharing someone else’s personal items.

Be sure to wash your hands often and be cautious about touching objects when someone in your house has strep.


When Should I See a Doctor?

If you or a child in your care has a sore throat lasting longer than 48 hours, problems swallowing, or sudden rash, call your doctor.

Call 911 if you have any trouble breathing.

For your little ones, call the doctor right away if:

  • An infant is 12 weeks or younger and has a temperature of 100.4 F or higher
  • A fever goes above 104 F in any child

You should also contact her if:

  • A child younger than 2 has a fever lasting more than 24 hours
  • A child 2 or older has a fever for more than 72 hours

Your doctor will ask questions and do tests to find out whether you have strep or something else. It can look a lot like other illnesses, including:

One key sign of strep is how fast you or your child feels it develop. It comes on in about 72 hours.

Though most sore throats get better on their own, strep throat should be treated with an antibiotic. Follow all of the instructions on how much and how long to take it. You can help stop the spread of strep by treating it early. You also lower the chance of getting complications.


Your doctor tests for strep throat with a rapid antigen test. She swabs the back of your throat with a cotton-tipped stick to get a sample. You usually get results in about 20 minutes.

If the test is negative (meaning no signs of strep are found), the doctor may do what’s called a throat culture. She’ll take more swab samples from the back of your throat and send them to a lab. You may have to wait a couple of days for those results.

When you call your doctor’s office to make your appointment, ask what details they need and instructions they might have. These may include:

  • A list of symptoms
  • A list of the medications you or your child takes
  • Whether you need to fast
  • Whether you or your young one has had strep throat before
Medical Reference Reviewed by Louise Chang, MD on September 09, 2018


SOURCES: “Sore Throat.” (Nemours Children’s Health System): “Strep Throat.”

European Centre for Disease Prevention and Control: “Streptococcal pharyngitis (strep throat).”

Cleveland Clinic: “Diseases & Conditions: Strep Throat.”

Centers for Disease Control and Infection: “Is It Strep Throat?”

“Antibiotics Aren’t Always the Answer,”  “Scarlet Fever: A Group A Streptococcal Infection” and “Group B Strep Infection in Adults.”

American Family Physician: “Common Questions about Streptococcal Pharyngitis.”

Clinical Infectious Diseases: “Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America.”

American Academy of Pediatrics ( “When to Call the Pediatrician: Fever.”

Mayo Clinic: “Diseases & Conditions: Strep throat,” “Diseases & Conditions: Mononucleosis.”

PubMedHealth (National Center for Biotechnology Information): “Strep Throat: Symptoms.”

American Academy of Otolaryngology — Head and Neck Surgery: “Tonsils and Adenoids.” “Strep Throat: Symptoms.”

University of Michigan Health System: “Swollen Lymph Nodes.”