The Signs of Strep Throat

By Siobhan O'Grady

The Signs of Strep Throat

What is strep throat?

Strep throat is the most common form of bacterial infection of the throat and tonsils, resulting in inflammation and irritation. Strep throat is caused by different types of streptococcus bacteria. The severity of the condition differs from one type of bacteria to another. Not all sore throats are caused by streptococcus, as viral infections also result in sore throats. Viral infections are often associated with signs and symptoms of colds like sneezing, coughing and runny nose. If your child is experiencing a sore throat along with other cold symptoms, it may indicate that strep throat is not the cause of your child's suffering. However, when it comes to the common cold and sore throat in children, it is more beneficial to be safe.

10 warning signs of strep throat

What are the signs of strep throat? Just like any other type of disease or infection, strep throat is also accompanied by some giveaway signs and symptoms that may give you a warning before taking your child to the doctor.

Some of the signs of strep throat may be similar to those of other conditions common in childhood, such as tonsillitis and sinusitis. However, some of the early signs of strep throat are unique and can help rule out other diseases. A medical test can better diagnose strep throat if the signs are contradictory or confusing.

Below is a list of 10 signs of a strep infection seen in both adults and children.

1. Sore throat

Sore throat is one of the first telltale signs of strep throat. According to current research, sore throat is one of the most common strep throat signs that affects infants and children. However, this sign is not as severe in adults. With a sore throat, your child may experience pain and sore, inflamed, red throat tissue that comes as a result of severe viral or bacterial infection and irritation.

As previously mentioned, the major cause of strep throat is group A streptococcus bacteria. But a sore throat can be caused by viral infections, allergies, fungal infections, and environmental irritants such as cigarette smoke and other pollutants that would make your throat feel scratchy and painful. 

With a sore throat, your child's doctor may suspect strep throat before other severe infections such as sinusitis and tonsillitis. A quick throat swab can help determine whether your child has strep throat caused by group A streptococcus or not.

2. Swollen glands

Swollen glands are another sign of strep throat that is not present in other conditions. You should feel for any swollen lymph nodes found on the sides of your child's neck if you suspect strep throat. This will help you rule out inflamed tonsils, as they too cause your child pain when swallowing. In many cases, your doctor will not diagnose strep throat with such a sign right away. However, a medical test and a throat swab are needed to help detect whether group A streptococcus bacteria is present. Group A streptococcus bacteria usually live in the noses and throats of humans without causing any infection. In many cases, over-excess of this bacterium is what causes strep throat after the bacteria overloads the throat.

If your child makes direct contact with an infected person, then they are likely to spread this bacterium. More precisely, you or your child can get strep throat after contact with body fluids of an individual with strep throat. Such fluids may come through cough and sneeze droplets. With this in mind, instruct your children to wash their hands frequently to prevent contact of infected droplets that may later make contact with other body parts via the hands. 

3. Red and swollen tonsils

In many cases of strep throat, the infection spreads to the tonsils, causing swelling and redness. You may also see yellow or whitish spots on the tonsils. In severe cases, streaks of pus that cover the tonsils can be visible when investigating the throat. In some rare cases, you will find red spots that appear on the tissue surrounding the tonsils. You may confuse these signs with those of tonsillitis. If the cause of swollen tonsils is unclear, then your doctor may go for a strep-check to see if a streptococcus bacterium is responsible for the infection. If strep test results are positive, then your child might be given a dose of antibiotics to treat the signs.

4. Fever with chills

With strep throat, your child may experience mild fever of up to 100 degrees Fahrenheit. This fever can be accompanied by night sweats and chills that may decrease body fluid level as the body tries to fight the infection. As strep throat will increase the need for more body fluid, you should make sure your child drinks enough fluids to help replace the loss and prevent dehydration. If high fever is accompanied by other strep throat signs, then you should go for a strep throat test to determine the cause of the illness. Strep throat is a highly contagious infection, and those who have it should take possible precautions to prevent further spreading.

5. Vomiting and stomach problems

In some cases, particularly in toddlers, strep throat signs that are differently related to symptoms of the throat may occur. Though uncommon, young children may experience nausea, stomach aches, and vomiting. Vomiting can ultimately lead to dehydration in young children. When your child has such signs, they may last as long as swollen lymph nodes and throat aches do. Nausea and stomach aches may appear alongside, or even after throat-related signs appear. This can help differentiate between early-stage gastric problems and strep throat.

6. Swallowing problems

Strep throat will cause difficulty in swallowing, which will also make it hard for your child to drink enough fluids that will help fight the infection. If your child has swallowing difficulties, then you should try giving gentle fluids such as honey, herbal teas, and warm soup broth among others. This can help the body get enough fluids and avoid dehydration. Children may also have difficulties while eating when they are battling strep throat. This may not worry you as a parent as this is caused by irritated, raw, and inflamed throat tissue. Instead, you should try to make your child adequately hydrated to help boost the immune system and fight the infection.

When you experience signs of strep throat, it is important to wash your hands regularly to avoid spreading the infection to others. You should also not share kitchen utensils to prevent exchange of saliva. While coughing or sneezing, you should always keep your mouth completely closed. Teach your child to do the same. 

7. Skin rashes

Skin rash is one of the most common first signs of strep throat in toddlers. However, adults with weak immune systems can also experience a skin rash. Skin rash comes as a result of an allergic reaction against the strep bacteria as well as chills and fever.

Rash can be experienced in the form of small bumps that show up on the chest, back, neck, and the torso area. You or your child may also experience tiny red spots on the back or even on the roof of hard and soft palate of the mouth. Such condition is called petechiae. Some bacterial strains causing strep throat may also cause a fever-like rash that is almost similar to scarlet fever. Sandpaper-like rashes may also appear first on your neck or chest before spreading to the torso area and the whole body.

A prescription of antibiotics can help reduce the symptom of discomfort and also quicken healing. Antibiotics can prevent further spread of the infection as well as preventing serious complications such as tonsillitis, sinusitis and acute rheumatic fever.

8. Headache

Headache usually comes as a result of dehydration in patients with strep throat. However you can get flu-like symptoms together with fever which can cause you or your child headache. Many people may ignore such symptoms. Fever is also common in people with strep throat, as the body tries to fight foreign bacteria. If fever persists even after having a dose of antibiotics, you should consult your doctor immediately.

In case you catch strep throat, your doctor will prescribe you some medications to help you boost the body's immunity and also relieve symptoms such as headache. The prescription can also help quicken the time of recovery. You should follow the dosage exactly as instructed and finish the whole prescription even if you start feeling well and think that you don't need it anymore. If you or your child abruptly stops a course antibiotics for example, you will increase the risk of re-infecting yourself and infecting others as well. Make sure your child finishes the entire prescription dose as well. 

9. Muscle pain

Just like other types of infections such as colds and influenza, your child will have sore and achy muscles. You will also have common flu-like symptoms such as neck and head pain, plus stiff joints as your body tries to fight bacterial infection. You can also have your neck lymph nodes and glands swollen, hot, and tender to touch. Such signs of strep throat can be relieved by the use of amoxicillin or penicillin which can be prescribed for a period of 10 days to be taken every day.

10. White patchy throat

A white, patchy throat may be also as a result of winter allergies, or cold or dry air. However, if the patient has strep throat, the highly contagious group A bacteria can make the throat sore and inflamed which can persist for months if it goes untreated. In some severe cases, your child can have red, swollen and a white-patched throat with visible pus spots on the tonsils. Strep throat can also leave white patches on the back of the mouth as well as on the tonsils and throat. Such white patches can also be accompanied by red and swollen tissues.

Managing signs of strep throat

Before and after treatment of strep throat, the following home remedies can help manage strep throat signs and symptoms and make your child feel better. They include:

  • Rest: Staying away from school is one way of giving your child a rest. Plus, your child should not attend school while he or she is still contagious.
  • Over-the-counter painkillers: Some OTC medications such as ibuprofen, acetaminophen and Advil can help relieve signs such fever and sore throat. Speak with your doctor before administering any painkillers to your child.
  • Gargling: You should rinse your mouth or gargle with salty water to help relieve your scratchy throat. Salty water can be made by mixing a quarter teaspoon of salt with 8 ounces of water.
  • Hard candy and lozenges: Older children can suck on lozenges to feel better. You should avoid giving small pieces of hard candy to children less than 4 years old, as it can choke them or block the food pipe when swallowed.
  • Drink plenty of fluids: If your child has a fever, it means the body is using a lot of fluid when fighting infections. Water and warm fluids such as herbal tea and soup broth can help keep your child hydrated. If cold fluids make your throat feel better, you can suck on frozen pops or ice chips. You should avoid fluids such as orange juice, lemonade and other fluids that are rich in acids. Such fluids can bring a burning sensation to the throat which can be painful.
  • Soft foods: You should always stick to soft foods to avoid scratching your sore throat. Such foods include frozen yogurt, mashed potatoes, normal yogurt, and applesauce. These foods are easy to swallow and are not likely to make your child's throat feel painful.

When to see your doctor

You should immediately see the doctor if you or your child has the following signs and symptoms of strep throat:

  • Difficulties when swallowing or breathing
  • Sore throat accompanied by skin rash
  • Sore throat accompanied by swollen and tender lymph nodes
  • Sore throat lasts for more than 48 hours
  • If after diagnosis and treatment, your sore throat lasts for more than 48 hours
  • Chills and fever of more than 101 F
  • Fever lasts for more than 48 hours

Diagnosis of strep throat

Your doctor can easily diagnose strep throat by use of medical history and a physical examination of the throat. Other tests that can be used to diagnose strep throat are throat cultures, lab tests, and use of strep throat major signs and symptoms. Sometimes your healthcare professional can use a rapid strep test to check for strep bacteria. Rapid strep test results can be confirmed by use of a throat culture.

According to the current treatment guidelines, your healthcare providers should confirm strep throat with a lab test such as throat culture, but not by use of strep throat signs and symptoms. However, your doctor can start your treatment before the results of your throat culture are back if you have the following signs and symptoms:

  • Yellow or whitish spots that have coated your throat or tonsils
  • Tender and swollen neck lymph nodes
  • A recent fever that elevates beyond 100 F 
  • Absence of cold signs and symptoms such as sneezing, coughing, and upper respiratory infections

While confirming the diagnosis of your strep throat, your doctor may consider using one or both of the following tests:

  • Throat Culture: It is a test that is used to find germs such as bacteria that may cause an infection. During throat culture, a sample of your throat cells is taken and then added to a substance that will help promote the growth of bacteria. If there is no growth of bacteria on the culture, then the test is negative. If bacteria grow on the culture, the test is positive.
  • Rapid Strep Test: It is a test which analyzes bacteria on your throat to see if strep A bacteria is the cause of the infection. Your doctor uses a cotton swab to gather a sample of cells from the back of your throat for analysis.

If signs of strep throat are present, then it is important to be tested for group A strep infection. Immediate treatment is necessary to help reduce the chances of spreading the infection and also reduce the chances of future complications such as sinusitis and abscess around the tonsils.

If your child must be tested for strep throat, the choice between throat culture and rapid strep test can be contradicting. Discussing with your doctor about the merits and demerits of each procedure can help you choose which test to undergo. For example, tests for rapid strep tests are ready after about 15 minutes, while those of throat culture are available after one to two days. On the other hand, throat culture is more accurate compared to rapid strep test. In many cases, doctors perform both exams. 

Strep throat spreads easily through contact and tiny droplets in the air that contain the bacteria through sneezing or coughing. The person who inhaled the infected droplets may show symptoms within two to five days.


Treatment of strep throat

Antibiotics such as penicillin, amoxicillin and cephalexin are usually used to treat strep throat. Antibiotics always work against major bacterial infections such as strep throat. However, they cannot help reduce signs and symptoms of strep throat such as sore throat and other sore throat conditions caused by colds, allergies and viral infections.

Antibiotics are mainly used to:

  • Relieve discomfort caused by strep throat and quicken the healing time
  • Kill the bacteria and shorten the time you are likely to spread the infection
  • Prevent some rare complications such as sinusitis and tonsil abscess

Treatment with antibiotics should start immediately after strep throat has been confirmed by a throat culture or rapid strep test. If you fail to treat the infection early, you can make the signs of the infection more severe and also increase your risk of future complications such as rheumatic fever, abscess of the tonsils, and sinusitis. 

Prevention of strep throat

Avoiding contact with someone who has the infection is the best way to prevent strep infection. Sharing utensils, toothbrushes and drinking from the same glass increases the chances of infection and hence should be deliberately avoided. Washing hands regularly is a good habit and helps to reduce the chances of infection as the bacteria may live for a short period of time on door knobs, faucets and other objects. Teach your children these prevention methods. 

If you have the infection, use tissue instead of handkerchiefs to avoid spreading the infection to others. Ensure not to sneeze or cough on others. Take a day off from work or school to avoid spreading the bacteria.

Complications of untreated signs of strep throat in toddlers

The following are complications which your may have if you don’t treat strep throat signs and symptoms:

  • Rheumatic Fever: Rheumatic fever may develop if you have untreated strep throat signs. In some rare cases, the strep bacteria can enter the bloodstream and travel to the heart where it adheres to one of the heart valves. The bacteria can then cause infection to the valve causing the heart to malfunction. Symptoms of such a condition include trouble in breathing and swallowing. This will require you or your child an immediate evaluation by the doctor. An intravenous injection of antibiotics can help treat such a condition.
  • Abscess: Throat infection can spread to the surrounding neck tissues but in rare cases. Once the infection has invaded the neck tissues, it causes a large and infectious neck, which is known as peritonsillar abscess. In a child, the swelling is usually found on the side of the neck which can cause problems when breathing or swallowing. Such a condition requires an emergency evaluation and an intravenous injection of antibiotics.
  • GlomerulonephritisThis is a term used to describe inflamed kidneys. This is not an infection of the kidneys by strep bacteria, but it occurs when your immune system provides antibodies targeting the strep infection and the kidneys as well. This can make your kidney stop working temporarily and there may be a presence of blood in the urine.
  • Scarlet FeverThis is mainly a complication of strep throat in toddlers. It is an allergic type of reaction to the strep bacteria. It can result in a pimply, red and rough-feeling rash on the entire body. Scarlet fever is not as dangerous as strep throat, but the child can feel more ill. Treatment of scarlet fever has not yet been identified, but prescription of antibiotics can make your child feel better.