Signs and Symptoms of Strep Throat

Strep throat isn't the most common cause of a sore throat, but it can be one of the most painful. Aside from the telltale pain, other characteristic symptoms of strep include swollen lymph nodes and a red rash in your mouth.

Strep throat is caused by a type of bacteria called group A Streptococcus pyogenes. The infection is most common in kids ages 5 through 15 years old, according to the Centers for Disease Control and Protection (CDC). As a result, parents of kids in this age group and adults often around children also have an increased risk of infection.

If left untreated, strep can cause serious problems, like rheumatic fever, heart valve damage, and sepsis, or blood poisoning.

The good news is that strep throat is easily treated with antibiotics if it's diagnosed correctly. "It would not be good if someone were to not come in to get a diagnosis and then end up with complications when it is so easy to treat," said Aaron Prussin, MD, assistant professor of otolaryngology-head and neck surgery at the University of Utah School of Medicine. The CDC says antibiotics should help a person with strep feel better in a day or two. Quick diagnosis and treatment can prevent complications from developing.

Know these signs of strep throat so you can zap it early.

01 of 07

Sore Throat

Not surprisingly, a fiery sore throat is the hallmark symptom of strep throat, and it is often one of the earliest symptoms. A sore throat also makes it painful to swallow.

Sore throats can signify many other illnesses, notably upper respiratory infections like colds or tonsillitis. This makes it difficult–but not impossible–to tell the difference.

A sore throat from strep usually comes on quickly, not slowly, and lasts more than a day or two. It also doesn't come with typical cold symptoms like a cough, runny or stuffy nose, or hoarseness. The CDC reports it takes about two days for someone to experience strep throat symptoms after being exposed.

"None of those other symptoms are seen in streptococcal sore throat, or at least not typically," said Michael Grosso, MD, medical director and acting chair of pediatrics and chief medical officer at Huntington Hospital in New York.

Antibiotics, usually in the penicillin class, may shorten the duration of strep. They could also prevent more serious complications, including abscesses, sinus and ear infections, and post-streptococcal glomerulonephritis (a rare kidney disease), according to the CDC.

02 of 07

Swollen Lymph Nodes

Lymph nodes play a role in cancer diagnoses, as well as trapping bacteria and viruses. When you have strep throat, you may be able to feel your swollen, tender lymph nodes in your neck by gently touching the area.

03 of 07

Fever

Another classic symptom of strep throat is a fever. It's one among "a constellation of symptoms physicians have traditionally been trained to look for that are more indicative of strep throat," explained Dr. Rupp.

The presence of a fever can help differentiate strep from a sore throat caused by a cold, which usually doesn't cause an elevated temperature. "We look for the absence of symptoms that are more indicative of a viral upper respiratory infection, like cough and nasal congestion," Dr. Rupp said.

Although symptoms can differ, strep is spread much the same way as colds and other respiratory infections: through droplets expelled by sneezing or coughing. If you come in contact with those droplets, you might pick up the bug. Washing your hands and avoiding touching your face are good ways to prevent the spread of strep.

The CDC recommends people with strep throat stay home from work and school to avoid further spread until they no longer have a fever and have been on antibiotics for at least 12 hours.

04 of 07

Swollen Tonsils

Tonsils are actually lymph nodes in the back of the mouth, and they, too, become enlarged with strep throat.

The larger size of the tonsils should be apparent when you look at the back of your throat. "Open your mouth wide and shine a light directly in or bounce it off a mirror," said Dr. Rupp. The tonsils may also look red or have white patches or streaks.

Even if you don't have tonsils, you can still get strep, though it's not as common.

If someone is getting strep frequently, doctors often recommend having the tonsils removed. "It probably means bacteria are just hanging out in the tonsils," Dr. Prussin said. If you've had three bouts of strep a year for the last three years, five infections a year over the previous two years, or a whopping seven infections in the past year, you might be a good candidate for the surgery, Dr. Prussin said, although those guidelines can be adjusted person to person.

05 of 07

Red Spots or Rash

A red rash, called petechiae, often appears toward the back of the roof of the mouth in people with strep throat. "When we see the spots on the roof of the mouth, we can say with a fairly high grade of confidence that we're looking at strep," said Dr. Grosso. You still need a lab-confirmed diagnosis, though—doctors will use a rapid antigen detection test (RADT) and collect a throat culture, which the CDC calls "the gold standard diagnostic test" when someone presents strep symptoms.

A red rash on the skin also caused by group A strep bacteria is known as scarlet fever and can accompany strep throat. This differs from the scarlet fever that was a leading cause of death among children in the 18th and 19th centuries. "That's not the clinical behavior of the condition we see [now]," said Dr. Grosso. Scarlet fever related to strep throat is mild and should go away quickly with a course of antibiotics.

06 of 07

Nausea and Vomiting

Nausea and vomiting resulting from strep throat aren't all that common. If they do happen, it's more often in younger children.

It's more likely nausea and vomiting are a result of a viral infection, not a bacterial infection like strep, said Philip G. Chen, MD, assistant professor and program director of rhinology in the otolaryngology-head and neck surgery department at the University of Texas Health Science Center.

However, everyone's experience with strep throat is slightly different. The chemicals your body creates as the immune system ramps up to fight infection can lead to several symptoms, including fatigue, nausea, vomiting, fever, and more, Dr. Chen said. "Talk to your physician about your specific symptoms."

07 of 07

Headache

Headaches are another possible symptom of strep throat, especially in children over 3. Again, the presence of other strep throat symptoms and a lab test can confirm this.

Without a sore throat, it's more likely your headache is due to some other cause. "It's important to be a little judicious about doing testing where it's unlikely to be strep," Dr. Grosso said. Over-testing can lead to over-treatment with antibiotics. Overuse of these medicines can contribute to antibiotic resistance when strains of bacteria become resistant to treatment.

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