Strep Throat

Strep throat is a bacterial infection that affects your throat and tonsils. Group A Streptococcus bacteria, also called group A strep, cause it. Strep throat is common, especially in children ages 5 to 15. But people of any age can get it.

Strep throat can cause a sudden, painful sore throat, fever and swollen lymph nodes in your neck. But not every sore throat is strep throat. In fact, viruses — not bacteria — cause most sore throats.

You can’t know for sure that you have strep throat based on symptoms alone. A healthcare provider may swab your throat for a rapid strep test or throat culture. If the test confirms strep, antibiotics can help you feel better sooner, make you less contagious and reduce your risk of complications.

Strep throat symptoms

Symptoms of strep throat often start quickly. Common signs and symptoms may include:

• A sore throat, especially one that starts suddenly
• Pain when swallowing
• Fever and/or chills
• Red, swollen tonsils
• White patches or streaks of pus on your tonsils
• Swollen lymph nodes in the front of your neck
• Tiny red spots on the roof of your mouth (petechiae)

Children may also have strep symptoms, like:

• Headache
• Nausea or vomiting
• Belly (abdominal) pain
• Not wanting to eat
• A red rash that feels rough, like sandpaper

Some people with strep throat develop a widespread rash, which can be a sign of scarlet fever. The same type of bacteria causes both strep throat and scarlet fever.

What does strep throat look like?

Strep throat may make your throat and tonsils look red and swollen. There may be white spots or streaks on your tonsils. You may also see pinpoint-size red dots on the roof of your mouth.

But how your throat looks can’t tell you for sure whether you have strep. Other infections can cause similar changes. A healthcare provider may need to do a test to confirm the cause.

How do you get strep throat?

The bacterium Streptococcus pyogenes, or group A Streptococcus, causes strep throat. The bacteria infect the tissues in your throat and tonsils.

Strep throat is different from a viral sore throat. A cough, runny nose, hoarse voice, mouth sores or pink eye are more likely to point to a virus.

Is strep throat contagious?

Yes. Strep throat is contagious. Group A strep bacteria can spread through droplets when someone talks, coughs or sneezes. You can also get the bacteria by touching something with infected droplets on it and then touching your nose or mouth. Sharing cups, plates or utensils with someone who has strep can spread the bacteria, too.

You usually develop symptoms about two to five days after being exposed to the bacteria.

How long is strep throat contagious?

Without treatment, you may continue spreading the bacteria while you’re infected. Antibiotics greatly reduce your body’s ability to spread strep. Once you start the right antibiotic, you’re much less likely to spread strep after about 12 to 24 hours.

Risk factors

Anyone can get strep throat. But your chances are higher if you:

• Are between the ages of 5 and 15
• Have close contact with someone who has strep throat
• Live with or care for school-age children
• Spend time in crowded settings, like schools or daycare centers

Strep throat is rare in children younger than 3.

Complications of strep throat

Complications from strep throat aren’t common. But they can happen if the infection spreads or causes an immune response elsewhere in your body.

Possible complications include:

• An abscess (pocket of pus) around your tonsils or in your neck
• Ear or sinus infections
• Post-streptococcal glomerulonephritis, a type of kidney disease
• Rheumatic fever, which can affect your heart, joints, brain and skin

Taking antibiotics as prescribed lowers the risk of some complications.

How doctors diagnose strep throat

Your healthcare provider will ask about your symptoms and examine your throat and neck. They’ll look for signs that make strep more or less likely.

But symptoms and an exam alone usually can’t confirm strep throat. Your provider may swab the back of your throat and tonsils to test for group A strep bacteria.

Tests may include:

• Rapid strep test: This test checks a throat swab for group A strep and provides results quickly.
• Throat culture: A lab checks your throat swab to see if group A strep bacteria grow. Results take longer, but a culture may find an infection that a rapid test misses.

A throat culture is the gold standard for diagnosing strep throat. If your child is older than 3 and tests negative on a rapid test, their provider may confirm the result with a throat culture. Adults usually don’t need a follow-up culture after a negative rapid test.

Strep throat treatment

If testing confirms strep throat, your healthcare provider will treat you with antibiotics. Penicillin and amoxicillin are common first choices. If you have a penicillin allergy, your provider can choose another antibiotic that’s safe for you.

Antibiotics for strep throat can:

• Help you feel better sooner
• Reduce how long you’re contagious
• Reduce the chance of spreading strep to other people
• Lower your risk of certain complications

Take your antibiotic exactly as your provider prescribes it. Don’t stop taking it just because you feel better.

You can also ease strep throat symptoms by:

• Drinking plenty of fluids
• Getting extra rest
• Gargling with warm salt water
• Using throat lozenges or ice chips if they’re safe for your age
• Taking acetaminophen (Tylenol®) or ibuprofen (Advil®) for pain or fever

Don’t give aspirin to children or teenagers unless their healthcare provider specifically recommends it.

Strep throat may go away on its own. But healthcare providers recommend antibiotics for a confirmed strep infection. Treatment helps symptoms go away sooner, reduces the spread of bacteria and lowers the risk of complications.

How long does strep throat last?

Most people start to feel better within a day or two after starting antibiotics. Children typically recover within a few days.

Contact your healthcare provider if you’ve been taking antibiotics for more than 48 hours and your symptoms aren’t getting any better.

When should I see my healthcare provider?

Seek urgent medical care if you or your child has:

• Trouble breathing
• Severe trouble swallowing or drooling
• Severe swelling in your neck
• Severe or worsening pain on one side of your throat
• Signs of dehydration, like fatigue, dizziness or headache
• Symptoms that are quickly getting worse

What can I expect if I have this condition?

Strep throat usually clears up quickly with antibiotic treatment. Most people begin feeling better within one or two days.

You can get strep throat more than once. Having it doesn’t give you lasting protection against another infection.