Sore throats are common, often causing discomfort. Many people experience a scratchy or painful throat. Distinguishing between a viral infection and strep throat is important for determining the right course of action. Understanding the cause helps in seeking appropriate care and preventing complications.
Identifying Core Symptoms
Viral sore throats, often part of a common cold or flu, typically have a gradual onset. Symptoms may include sneezing, a runny nose, coughing, hoarseness, general body aches, and malaise. The throat might feel scratchy or irritated.
Strep throat, caused by Group A Streptococcus bacteria, usually begins suddenly with a severe sore throat. Pain when swallowing is common, and tonsils may appear red, swollen, with white patches or streaks of pus. Tiny red spots (petechiae) can also be present on the roof of the mouth. Unlike viral infections, strep throat typically lacks cold symptoms like coughing or sneezing. Other signs include fever, headache, stomachache, nausea, or vomiting, particularly in younger children.
When to See a Doctor
While many sore throats improve with self-care, certain indicators suggest a need for medical evaluation. Consult a doctor if a sore throat persists for more than two to five days, or if pain is severe and makes swallowing difficult. Also seek care for a high fever, especially above 101°F (38.3°C).
Other signs needing medical attention include swollen lymph nodes in the neck, a rash (which could indicate scarlet fever), or difficulty breathing. Also seek advice if there has been a known exposure to someone with strep, or if symptoms do not improve after 48 hours on prescribed antibiotics.
Diagnosing Strep Throat
If strep throat is suspected, doctors perform a physical exam, checking for characteristic signs like red, swollen tonsils or white patches. The primary diagnostic tool is a rapid strep test, which involves swabbing the back of the throat. This in-office test detects Streptococcus bacteria within minutes.
If the rapid test is negative but strep is still strongly suspected, particularly in children and adolescents due to the risk of complications, a throat culture may be performed. This involves sending a swab to a lab to grow bacteria, providing a more accurate diagnosis, though results take 24-48 hours. The throat culture confirms the diagnosis, ensuring strep throat is not missed.
Treating Strep Throat
Once diagnosed, strep throat is typically treated with antibiotics. Penicillin and amoxicillin are commonly used choices for this bacterial infection. Prompt treatment reduces symptom duration, minimizes complications, and prevents spread of the infection to others.
The full 10-day course of antibiotics must be completed, even if symptoms improve quickly. Stopping antibiotics early can lead to recurrence and potentially serious health issues. Supportive care like over-the-counter pain relievers, throat lozenges, and warm liquids can also alleviate discomfort.
Risks of Untreated Strep
Untreated strep throat can lead to serious health complications if the bacteria spread to other parts of the body. One significant complication is rheumatic fever, an inflammatory condition affecting the heart, joints, brain, and skin. Though rare in developed countries, it can cause permanent heart valve damage.
Another potential complication is post-streptococcal glomerulonephritis, a kidney disorder where filtering units become inflamed. This can develop about 10 days after infection. Less common issues include peritonsillar abscesses (pus pockets around tonsils). Timely diagnosis and complete antibiotic treatment are important to prevent these serious outcomes.