What Strep Throat Symptoms Should Send You to a Doctor?

Strep Throat

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Strep throat is an infection of the throat caused by a bacteria  (group A beta-hemolytic streptococci pyogenes or GABHS). This type of bacteria often lives inside the nose and throat and doesn't always make us sick. It is a common infection that can occur in individuals of all ages but is most common in individuals ages 5-15 years. It is often spread through saliva, being coughed or sneezed on by someone who is infected or sharing a glass or food with an infected individual.

When evaluating the symptoms of strep throat it is important to remember that many other conditions can cause a sore throat including viral infections, allergies, and irritants such as chemicals like cigarette smoke.

Strep throat symptoms vary widely from person to person. Some individuals may have all of the symptoms listed below while others may only have one or two of the symptoms. Symptoms of strep throat include:

  • sore throat (often severe)
  • red throat sometimes with white patches on it that may look like pus
  • little red spots on the roof of the mouth (petechiae)
  • tonsillitis
  • difficulty swallowing or pain when swallowing
  • fever (often over 101 degrees)
  • chills
  • swollen lymph nodes (especially in the neck)
  • appetite loss
  • fatigue
  • a rash on the body which begins on the neck and chest and may feel like sandpaper
  • headache

Less common symptoms that can occur with strep throat include muscle aches, joint stiffness, a bad taste in the mouth, nausea, vomiting, abdominal pain and neck pain.

While strep generally does not cause coughing, sneezing or nasal congestion, there are rare occasions when these symptoms do occur. Severe symptoms that may require immediate emergency medical care include:

  • constant drooling
  • difficulty breathing
  • bluish coloration to the lips or skin (cyanosis)
  • inability to swallow
  • high fever that is not coming down with at home treatment such as the administration of acetaminophen or lukewarm baths

The only way to tell if you have strep throat is by seeing your doctor and having either a rapid strep test or a throat culture. Because strep throat is caused by a bacteria, it must be treated with an antibiotic. Symptoms usually start to improve within 24 hours of started an appropriate antibiotic. If your symptoms do not improve within 24 hours after starting an antibiotic you should call your doctor.

Untreated strep throat can cause serious complications such as scarlet fever, rheumatic fever, or kidney problems (post-streptococcal glomerulonephritis). This is why it is so important to see your physician if you have symptoms of strep throat. Rare complications of strep throat can cause the following symptoms:

  • scarlet fever is usually accompanied by a sandpaper-like rash and sometimes a red bumpy tongue in addition to other strep throat symptoms
  • joint pain or arthritis
  • swollen joints
  • joint stiffness
  • chest pain, difficulty breathing, heart problems
  • decreased urine output
  • rust colored urine
  • generalized swelling throughout the body especially in the abdomen, face, eyes, feet, ankles or hands
  • bloody urine

As previously mentioned, complications of strep throat are rare but serious. They are thought to be caused by an abnormal reaction of the immune system. Complications usually occur a few weeks after having strep throat.


CDC. Is it Strep Throat? Accessed: February 22, 2016 from http://www.cdc.gov/features/strepthroat/

Medline Plus. Strep Throat. Accessed: September 15, 2009 from http://www.nlm.nih.gov/medlineplus/ency/article/000639.htm

Medline Plus. Post-Streptococcal glomerulonephritis. Accessed: February 22, 2016 from https://www.nlm.nih.gov/medlineplus/ency/article/000503.htm

Medscape. Rheumatic Fever. Accessed: February 22, 2016 from http://emedicine.medscape.com/article/236582-clinical

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