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Strep Throat: Symptoms & Best Way to Treat

An open mouth with strep throat.
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Written by Bina Choi, MD.
Pulmonary & Critical Care Fellow, Brigham and Women's Hospital
Last updated February 18, 2021

Strep throat quiz

Take a quiz to find out if you have strep throat.

Care Plan

1

First steps to consider

  • See a healthcare provider if you have symptoms of strep throat, including pain when swallowing and a fever or white patches in your throat.
  • OTC pain relievers can help relieve symptoms like fever, throat pain, headaches, and body aches.
See care providers

Emergency Care

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Call 911 or go to the ER if you have any of the following symptoms:

  • Difficulty opening your mouth all the way
  • Difficulty swallowing saliva
  • Trouble breathing

Strep throat causes pain and redness in the throat—often with a fever. It is most common in children, but adults can get it, too. And it should always be treated with antibiotics.

Strep throat quiz

Take a quiz to find out if you have strep throat.

Take strep throat quiz

What is strep throat

Strep throat is a contagious infectious disease. (That means it can easily be passed on to a healthy person and make them sick.) It is caused by a group of bacteria called group A streptococcus (or group A strep).

These bacteria infect the throat and tonsils. (Tonsils are rounded areas located in the back of the throat. They help stop germs from entering the body.)

Strep is common in children. They are more likely to get it than adults.

A strep infection requires antibiotic treatment. Otherwise, it can lead to other serious health issues (including scarlet fever and rheumatic fever).

A red, swollen tonsil with white or yellow spots.

Dr. Rx

These are some of the signs I look for when diagnosing strep: Sore throat, painful lump in throat, swelling around neck of lymph nodes, high fever, no cough, younger age. - Dr. Bina Choi

Most common symptoms of strep throat

Strep symptoms include a very sore throat, swollen tonsils, and fever. Tonsils are usually red with streaks or yellow or white patches or spots. They are also probably tender. Eating and swallowing may be painful.

Lymph nodes in the neck may become swollen and tender—hurts when touched.

Infectious mononucleosis (“mono”) can cause similar symptoms. Mono needs to be treated to avoid complications.

It typically takes 2 to 5 days for a person who has been exposed to group A strep to notice symptoms.

  • A sore throat that usually starts quickly.
  • Fever higher than 100.4°F (or 38°C).
  • Red, swollen, and tender tonsils. Often with streaks/patches of white/yellow pus on the tonsils and back of the throat.
  • Difficulty or pain when swallowing.
  • Swollen and tender lymph nodes in the neck.
  • Headache and body aches.
  • Loss of appetite.
  • Tiny red spots on the roof of the mouth—though this is rare.

Strep throat quiz

Take a quiz to find out if you have strep throat.

Take strep throat quiz

Symptoms in kids

Kids may experience abdominal pain, nausea, and vomiting. This may be in addition to or instead of the other symptoms mentioned. Younger children may be extra fussy and sleep more than usual. Kids will usually develop a fever above 101°F or 38.3°C.

Children may also develop a rash with the fever. Typically, the rash first appears on the neck, underarm, and groin area. Then it may gradually spread over the whole body. The rash may be sandpapery. Sometimes there are small red bumps.

Strep throat causes

Pro Tip

An important question to ask your doctor about this illness is: what medications and situations should I avoid while taking this antibiotic? - Dr. Choi

Strep is very contagious. Spreading the infection is through direct contact, like kissing, sharing cups or utensils. Or even by touching shared surfaces or objects and then putting the hands in the mouth.

Strep throat spreads quickly among people in shared spaces. Especially at home, schools, childcare centers, or dormitories. It’s more common among children ages 5 to 15. But adults can get strep throat. Particularly parents, teachers, and childcare workers.

Frequently and thoroughly wash your hands for at least 20 seconds. Especially after contact with anyone who is sick, after coughing and sneezing, before preparing foods, and before eating.

A sneeze or cough spreads the virus.

Can strep throat go away on its own?

Because Strep throat is a bacterial infection, it does not go away without treatment.

If you have strep, your doctor will prescribe antibiotics, resting at home, medicines like acetaminophen or ibuprofen, and drinking water and fluids.

In addition to medication, you can try home care treatments.

  • Gargle with saltwater to soothe your throat. Mix ¼ teaspoon of salt in 8 ounces of warm water.
  • Use throat lozenges (cough drops).
  • Eat soft foods and cold foods like ice cream and popsicles.
  • Drink warm liquids like soup, broth, and teas.
  • Stay hydrated by drinking lots of clear liquids.
  • Avoid spicy, hot, or acidic foods/liquids.

Next steps

While strep isn't usually an emergency, you'll need antibiotics. Try to get an appointment within 24 hours or visit an urgent care center.

Sometimes, strep causes an abscess (a pocket of pus) within the tonsil—this can be very serious. While rare, if you notice any of the following symptoms, go to the emergency room or call 911:

  • Difficulty breathing.
  • Unable to swallow. (You may even start to drool.)
  • A muffled (hard to hear) voice.
  • Unable to open the mouth all the way.
  • If you have a weakened immune system. This includes having cancer, chemotherapy, HIV/AIDS, organ transplant, or history of an immunodeficient condition.

Strep throat quiz

Take a quiz to find out if you have strep throat.

Take strep throat quiz

How long is a person contagious with strep throat

Pro Tip

You should start feeling better after a day or two of antibiotics. Continue taking antibiotics for the full prescribed course, even if you feel 100% back to normal before you finish! - Dr. Choi

Avoid going to school or work until you’ve taken antibiotics for at least 24 hours, and you no longer have a fever.

Expect to start feeling better within a day or so of taking antibiotics. If you are not feeling well after finishing all the antibiotics, start feeling worse, or are unable to eat or drink, contact your doctor.

Go to the ER if you are having problems breathing or swallowing.

How do you know if you have strep throat or just a sore throat?

Your doctor will do a rapid strep test. The doctor will brush the back of the throat with a long cotton swab. The swab catches bacteria for testing. The test is called the rapid strep test. Results should be ready within an hour.

Sometimes, especially after a child has a negative test, the doctor will do another test called a throat culture. It takes at least a few days but can identify an infection missed by the rapid test.

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Pulmonary & Critical Care Fellow, Brigham and Women's Hospital
Dr. Choi is a board-certified Internist and current Pulmonary and Critical Care fellow at Brigham and Women’s Hospital. She completed her residency at Columbia University NewYork-Presbyterian Hospital, received her MD with a scholarly concentration in Health Services and Policy Research from Stanford School of Medicine, and received her BS from MIT. Her academic interests include clinical epidemio...
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