Sore throat vs strep symptoms: how to tell the difference

So, you wake up one morning with an itchy throat, inflamed and irritated. It’s probably just a harmless sore throat, right?

A sore throat (scientifically called pharyngitis) that seems uncomplicated could be the beginning of something more serious: strep throat. Understanding the difference between sore throat and strep throat can be the key to helping you get the right care for your illness. Let’s begin by distinguishing the symptoms.

Sore throat symptoms

A sore or itchy throat can be caused by many things, including allergens like pollen and dust, intolerances to food, or sometimes bacterial infections. The most common culprits are viral infections like influenza.

Pharyngitis caused by a virus or allergies often comes with other common symptoms, which may include:

  • A swollen, scratchy, itchy throat or tonsils
  • Congestion
  • Cough
  • Difficulty breathing
  • Earache
  • Itchy eyes if allergies are the cause
  • Lump on the neck (caused by swollen glands)
  • Moderate fever
  • Moderate rash
  • Runny nose

Strep throat symptoms

 While strep throat is painful like viral or allergic sore throats, it is caused by group A streptococcus bacteria, also known as Group A Strep. Bacterial pharyngitis symptoms are somewhat different than other sore throats, and may include:

  • A sore throat without cough/cold symptoms like a runny nose or congestion
  • Difficulty swallowing or breathing
  • Ear infection
  • Fever
  • Headache
  • Red and swollen tonsils, sometimes accompanied by white patches or streaks
  • Swollen lymph nodes (right below the earlobes)
  • Tiny red spots on the back of the roof of the mouth

Untreated, a strep infection may lead to:

  • An extreme rash, known as Scarlet Fever
  • Rheumatic fever

Scarlet fever and rheumatic fever can be serious illnesses, so it’s best to be proactive and see a practitioner at an urgent care clinic if you have strep symptoms. 

The difference between sore throat and strep throat 

The underlying difference between strep throat and sore throat is that it is strep caused by group A streptococcus bacteria, while other sore throats are caused by other types of bacteria, viruses or irritants like allergies.

Different types of pharyngitis also require different treatment plans and medications. Depending on the severity or the cause, a sore throat may only need home remedies to resolve the problem. However, with more severe signs of strep, like redness or white spots on the tonsils, patients should get a rapid strep test from a clinic.

Red sore throat

 One identifying symptom of bacterial pharyngitis like strep throat is having a red sore throat. A patient’s tonsils will look swollen and inflamed, a deeper color than the surrounding tissue. The redness may also look like streaks, or the patient may also notice tiny bright red spots on the throat and roof of the mouth.

White spots on throat

Another symptom of a bacterial throat infection is distinct white spots, splotches, or streaks on the tonsils, along with a red sore throat. If a patient notices this, it’s best to be seen by a clinician to get tested for strep. Testing is important because many infections are caused by less dangerous bacteria and don’t require antibiotic treatment. 

Home remedies for sore throat

Once a patient has a pharyngitis diagnosis, their care provider may recommend some of the following at-home remedies along with any appropriate medications.   

  • Gargle with warm salt water (1 to 5 ratio of salt to water) to help reduce swelling and relieve discomfort
  • Medicated throat lozenges
  • Throat sprays containing phenol
  • Warm liquids, such as honey & lemon tea or a broth soup
  • Warm or cool mist using a humidifier

Some patients choose to take an over-the-counter pain reliever for associated body aches and pains. Ask your care provider about medication safety for your condition. 

Diagnosis & treatment for strep throat

Providers can perform a quick strep test to look for antigens (indicator molecules) belonging to the bacterial strain Streptococcus A.

If negative...

You’re not out of the woods yet. The rapid strep test is good, but not perfect: about 15% of people with strep throat may have a negative test result.  If your provider still suspects strep throat, he or she can conduct a throat culture.

Results may take 1-2 days to return. If you have a sore throat, be sure to treat it either with a few home remedies or contact your local urgent care for a prescription to comfort you and get you through it.

If positive…

Sorry! You have strep throat. You will most likely be prescribed antibiotics and feel better within a few days. However, it is important that you follow the clinician’s instructions for taking the medication and finish it completely. If you don't, you’ll allow the bacteria that remain in your system to mutate and become more resistant to antibiotics.

You may also ask your provider about taking ibuprofen (such as Advil) or acetaminophen (like Tylenol) to reduce throat pain and fever symptoms.

Remember: Strep is very contagious and can lead to more serious illnesses.

Strep throat symptoms in children

While strep symptoms are basically the same for kids and adults, young children may have trouble communicating what they are feeling. Some clues that may prompt parents to check little throats for redness or white spots include:

  • Trouble swallowing or refusing favorite foods
  • Unexplained fever
  • Unusual drooling

Strep is very painful and can lead to more serious illnesses, so call your child’s primary care manager (PCM) or stop by an urgent care facility to request a rapid antigen test if you discover strep symptoms.

If your child is diagnosed with strep, keep in mind that it’s very contagious. Watch the rest of your family members carefully for symptoms, and keep your child away from others for at least 24 hours after starting antibiotic medications.

Your child should finish the medication exactly as prescribed, or there is a risk of a stronger reoccurrence of the infection. 

The difference in Treatment with strep throat

While less serious causes of sore throat may be successfully treated with home remedies, clinicians don’t mess around with strep throat. Once a patient has a positive strep test, providers typically prescribe oral antibiotics immediately following a strep diagnosis.

Penicillin or Amoxicillin is the most common antibiotic used to cure strep. A different antibiotic may be used if a patient is allergic to these options.

It’s important to know that viral pharyngitis is not curable with antibiotic medications. Bacteria and viruses are different kinds of microorganisms, and antibiotics are useless against viruses. Instead, a clinician may offer antiviral medicines depending on which virus is causing the problem.

Visit urgent care if experiencing any strep throat symptoms

Visit our Urgent Care if you’re experiencing strep or other sore throat symptoms. No appointments are necessary to visit urgent care and wait times are usually less than 15 minutes for walk-in patients. People who prefer appointments can make reservations online. 

We want to make it easy for you to take care of yourself and offer virtual visits seven days per week for patients who prefer to stay home. Virtual visits simply require a WIFI connection with the use of a laptop, tablet or cell phone. 

If you need help assessing and treating asthma, see the experts at urgent care. You can walk in without an appointment or check-in online. We’ll have you back to feeling better in no time.

Written by Sarah Thebarge, Physician Assistant