Symptoms of Strep Throat

How do you know you have strep throat? Getting the diagnosis right can help you avoid unnecessary antibiotics. Learn about the symptoms of strep throat.

When your throat is raw and irritated, it can be hard to tell whether you’ve caught a minor viral infection like a cold or a more serious bacterial infection like strep throat.

You might be tempted to ask your doctor for treatment before you know the cause. About 70 percent of the 15 million people who see their doctor for a sore throat each year walk away with an antibiotic prescription, yet only a small fraction of them have strep.

Taking an antibiotic for a viral disease like a cold or the flu isn’t a good idea because it contributes to the growing problem of antibiotic-resistant bacteria, or “superbugs.”

“Also, people need to understand that, by taking antibiotics for viral infections, they’re putting something in their bodies that they don’t need,” says Jeffrey A. Linder, MD, MPH, an internist and professor at Northwestern University in Chicago. “Taking antibiotics unnecessarily exposes people to adverse drug reactions, allergies, yeast infections, and nausea, with no benefit.”

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Symptoms of strep throat

The most accurate way to know whether you have strep is to get tested for it. But don’t run to your doctor’s office right away. First, use your other symptoms as a guide.

If you also have a cough, runny nose, and hoarse voice, you most likely have a virus and testing isn’t worth the trip.

Hallmark symptoms of strep throat that warrant a visit to your doctor or to your child’s pediatrician include:

• A fever
• Trouble swallowing
• Drooling
• Swollen neck glands in your neck
• Enlarged tonsils

Other symptoms may include a headache, stomach pain, nausea, or vomiting, especially in children.

People spread strep bacteria through talking, coughing, or sneezing, or direct contact with someone else. Symptoms can appear two to five days after exposure.

To diagnose strep, your doctor will take a throat swab. A rapid antigen detection test can find the presence of strep bacteria in just minutes. Yet the quick test doesn’t catch all cases of strep.

When the result is negative, doctors will sometimes do a backup throat culture — especially in children — to confirm the results. Results take one or two days, but the culture can more accurately distinguish bacterial from viral infections.

How to treat strep throat

Strep throat needs to be treated. Otherwise, the infection can spread to other parts of your body and lead to complications such as rheumatic fever (which can damage your heart and nervous system), kidney inflammation, and scarlet fever.

Researchers are also investigating whether strep might trigger or worsen psychiatric conditions such as obsessive-compulsive disorder or tic disorder in children. The rare syndrome is called pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.

To clear up the strep infection and prevent complications, doctors typically prescribe antibiotics.

“We recommend penicillin or amoxicillin for treating strep because they are very effective and safe in those who are not allergic, and there is increasing resistance of strep to the broader spectrum — and more expensive — macrolides, including azithromycin,” said Stanford T. Shulman, MD, professor emeritus at Northwestern.

If you take antibiotics, make sure to finish the entire course of medicine to ensure all the bacteria have been wiped out.

In the past, doctors recommended tonsil removal surgery for kids who had multiple strep infections. Today, tonsillectomy is reserved for children with more serious problems from strep, such as obstructed breathing.

How to treat a virus

Most viral sore throats aren’t cause for concern. They’ll go away in a week or two without treatment.

To soothe discomfort in the meantime, gargle with warm salt water, drink tea with honey, or take an over-the-counter pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil). (Don’t give aspirin or aspirin-containing products to children.)

Whether you have a cold or strep, follow the same advice. Stay home and rest until you feel better. You’ll get back on your feet faster and avoid passing your germs to anyone else.

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