Sore Throat vs. Strep Throat

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Man resting in bed, surrounded by used facial tissues; sore throat vs. strep throat?

Battling a sore throat can be extremely uncomfortable. It can also be difficult to tell whether you’re fighting a virus or dealing with a case of strep throat. Kelsey Redmond, ARNP, UnityPoint Health, explains the signs and symptoms of each, as well as the best treatment plan – including when you might need to make a trip to the doctor.

Strep Throat Symptoms 

While the symptoms of strep throat and sore throat seem similar, there are noticeable differences.

"When trying to tell the difference between a sore throat and strep throat, keep in mind strep throat is not often preceded by other symptoms that go along with a sore throat,” Redmond says. “If someone has symptoms of congestion, postnasal drip and cough and then complains of sore throat, that would indicate a possible viral infection. With strep, the sore throat is usually the first symptom."

Other signs of strep throat are fever, typically over 101, and swollen tonsils with white patches. Children may also experience headache, stomach pain, nausea or vomiting. 

How can you tell strep throat from a COVID-19 sore throat? Since COVID-19 is a viral infection, it usually feels a lot like other viral sore throats, coming on gradually and resolving after a few days. Generally, sore throat is not the main symptom, nor the only symptom, if you get coronavirus.

Viral Sore Throat vs. Strep Throat Treatment 

Based on your symptoms, if you believe you have strep throat, it’s very important to be seen by a health care provider. Once in the clinic, you’ll likely get a throat swab. If you get confirmation of strep, your care team will prescribe an antibiotic. It’s important to take your medication as recommended.

“When we test for strep throat, we are looking for strep A, but there are several other strep bacteria that may be contributing to your symptoms. The reason we look for strep A, specifically, is if it’s left untreated, it can cause rheumatic fever (inflammation of the heart, blood vessels and joints) or a kidney disease called post strep glomerulonephritis,” Redmond says.

Kids and adults alike who’ve been diagnosed with strep throat should stay home from school or work until they’ve been on antibiotics for 24 hours, and their fever subsides.

Sore throats caused by viral infections still might require being seen in the clinic, depending on the severity of symptoms, while others can be managed at home with over-the-counter medications like acetaminophen, ibuprofen, throat sprays and lozenges. Redmond says over-the-counter items can also help treat strep throat symptoms, too, but they don’t treat the infection. For that, you need an antibiotic.

Sore Throat Causes 

“There are many other causes of sore throat besides strep. Viral infections, dehydration, allergies, acid reflux and postnasal drip from nasal congestion can all contribute to sore throats. The most common viral illnesses that cause sore throats are the flu, mono and a common cold,” Redmond says.

She encourages everyone to watch symptoms closely and, when in doubt, contact your care team.

“Seek medical attention if you develop a fever over 100.4, are unable to swallow or your pain is severe. We are here for you,” Redmond says.

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