The Most Common Symptoms of Strep Throat

Antibiotics are required when a sore throat is due to Strep

Telling a Doctor About Her Sore Throat
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Strep throat is an infection of the throat caused by a bacteria  (group A beta-hemolytic Streptococcus 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 to 15 years. It is often spread through saliva, coughing, or sneezing 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 cigarette smoke.

Symptoms of Strep Throat

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. The biggest difference between strep throat and a cold virus is that strep throat usually does not cause a runny nose, congestion, sneezing or coughing.

Symptoms of strep throat include:

  • A sore throat that often starts quickly and can be severe
  • Inside, your throat and tonsils may be red, 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), which may begin suddenly
  • 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.

Severe Symptoms Requiring Emergency Care

Severe symptoms that may require immediate emergency medical care include:

  • Constant drooling
  • Difficulty breathing
  • Bluish coloration of 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

How to Tell If It's Strep Throat or Not

Unfortunately, many other conditions may cause some of these same symptoms including the common cold virus, mononucleosis, and even allergies. 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 begin to improve within 24 hours of starting an appropriate antibiotic. If your symptoms do not improve within 24 hours after starting an antibiotic you should call your doctor.

Complications of Untreated Strep Throat

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.