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Strep Throat

Condition Basics

What is strep throat?

Strep throat is a bacterial infection in the throat and the tonsils. The throat and tonsils get irritated, inflamed, and painful, causing a sudden, severe sore throat.

What causes it?

Strep throat is caused by streptococcal (strep) bacteria. There are many different types of strep bacteria. Some cause more serious illness than others. Strep throat is most often caused by group A streptococcus (GAS).

How does it spread?

Strep throat is spread through the air in droplets when an infected person breathes, coughs, or sneezes. You may then become infected after breathing in these droplets. Or you may get infected when the droplets get on objects or parts of your skin that come in contact with your mouth, nose, or eyes.

What are the symptoms?

The most common symptoms of strep throat are a sudden and severe sore throat, pain when you swallow, and fever. Other symptoms include swollen tonsils, large lymph nodes, and white or yellow spots on the tonsils. You may also have tiny red spots on the roof of your mouth, a headache, and belly pain.

How is it diagnosed?

Your doctor will examine you, ask about your symptoms, and do a throat culture or rapid strep test. A rapid test gives results within about 10 minutes. But sometimes it doesn't show strep even when you have strep. A culture takes 1 or 2 days, but it's better at finding all cases of strep.

How is strep throat treated?

Strep throat is treated with antibiotics. These drugs shorten the time you're able to spread the disease, and they lower the risk of spreading the infection to other parts of your body. Antibiotics may help you feel better faster. Taking an over-the-counter medicine like acetaminophen can help relieve pain and reduce fever.

Prevention

Try the following ideas to help prevent strep throat.

  • Avoid contact with anyone who has a strep infection.
  • Wash your hands often.

    This is especially important when you are sick or when you are around someone who is sick.

  • Do not share toothbrushes or eating and drinking utensils.
  • Cover your mouth when you cough or sneeze. If you can, cough or sneeze into the bend of your elbow, not your hands.

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Symptoms

The most common symptoms of strep throat are:

  • A sudden, severe sore throat without coughing, sneezing, runny nose, or other cold symptoms.
  • Pain when you swallow, or trouble swallowing.
  • Fever.
  • Swollen lymph nodes in the neck.
  • White or yellow spots or coating on the throat and tonsils.
  • Bright red throat or dark red spots on the roof of the mouth at the back near the throat.
  • Swollen tonsils.

You may also have a headache and belly pain. Less common symptoms are a reddish skin rash, vomiting, not feeling hungry, and body aches.

What Happens

Symptoms of strep throat most often start within 2 to 5 days after you come in contact with someone who has a strep infection. Strep throat most often starts to get better in 3 to 7 days with or without antibiotic treatment.

If strep throat isn't treated with antibiotics, you can still spread the infection for a few weeks even if your symptoms go away. If you start antibiotics, within 24 hours you are much less likely to spread the infection. With antibiotics, you also are less likely to get other problems from the strep infection.

Can strep throat cause other health problems?

Problems (complications) from strep throat are rare. But they can occur, especially if your throat infection isn't treated with antibiotics. Problems can occur when the strep infection spreads to other parts of the body. This can cause other infections, such as an ear or sinus infection or an abscess near the tonsils (peritonsillar abscess). Problems can also cause your immune system to attack your own body. This can cause serious conditions such as rheumatic fever and kidney problems.

Treating strep throat can greatly reduce your risk for rheumatic fever and other problems. It's not clear whether treating the strep infection with antibiotics lowers your risk for inflammation of the kidneys (acute glomerulonephritis).

When to Call a Doctor

Call 911 or other emergency services immediately if you:

  • Have severe trouble breathing.
  • Have trouble swallowing saliva.

Call your doctor now if you have:

  • A reddish rash that feels like sandpaper or a bright red tongue with tiny bumps. This may be a sign of scarlet fever.
  • Trouble sleeping because your throat is blocked by swollen tonsils or adenoids.
  • A severe sore throat on one side with swelling around one of the tonsils and a fever. These may be signs of peritonsillar abscess.

Call a doctor if the following symptoms develop 1 to 3 weeks or longer after a strep throat infection. These symptoms may be a sign of rheumatic fever or kidney problems.

  • Weakness
  • Shortness of breath
  • Joint pain
  • Raised red rash or lumps under the skin
  • Uncontrolled, jerking movements of the arms or legs
  • Swelling
  • Urine that is red or brown

Call your doctor if your symptoms don't improve after 2 days of treatment with an antibiotic.

Watchful waiting

Watchful waiting is a good choice if your sore throat occurs with symptoms like those of a cold, such as sneezing, coughing, and a runny or stuffy nose. In general, the more of these symptoms you have, the less likely it is that your sore throat is caused by a strep infection. You can try home treatment if your sore throat isn't severe and you have other symptoms of a cold.

Check your symptoms

Exams and Tests

Your doctor will examine you, ask about your symptoms, and do a throat culture or rapid strep test.

A rapid strep test analyzes the bacteria in your throat to see if strep is causing your sore throat. The doctor uses a cotton swab to gather cells from the back of your throat for testing. This test gives results within about 10 minutes. But sometimes it doesn't show strep even when you have strep. If the rapid test is positive and says that you do have strep, there's no need to do the throat culture.

A throat culture can find strep bacteria. A culture takes 1 or 2 days, but it's better at finding all cases of strep. A sample of cells from the back of your throat is added to a substance that promotes the growth of bacteria. If no bacteria grow, the culture is negative. If strep bacteria grow, the culture is positive.

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Treatment Overview

Doctors usually treat strep throat with antibiotics. These drugs shorten the time that you're able to spread the disease (are contagious) to others. And they lower the risk of spreading the infection to other parts of your body. They also may help you feel better faster.

Your doctor may also advise you to take an over-the-counter medicine like acetaminophen (such as Tylenol) or ibuprofen (such as Advil or Motrin) to help with pain and lower your fever. Be safe with medicines. Read and follow all instructions on the label. Don't give aspirin to anyone younger than 18. It has been linked to Reye syndrome, a serious illness.

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Self-Care

Your doctor may have prescribed an antibiotic for strep throat. Take all of the antibiotic exactly as prescribed. This will help prevent the infection from coming back and will prevent complications of infection that could occur if you do not take the medicine as prescribed.

There are many ways that you can make yourself feel better while you are waiting for the strep infection to go away.

  • Stay hydrated.

    Drink plenty of fluids and increase humidity (moisture in the air) in your home to help keep your throat moist. Herbal teas formulated for colds and other warm liquids may help relieve symptoms. Frozen liquids like ice or flavoured ice pops (such as Popsicles) may help too.

  • Get plenty of rest.

    Stay home the first day of antibiotic treatment. You are still contagious and might pass the infection to others. Rest in bed if you feel very sick.

  • Treat your symptoms.
    • Take non-prescription medicines to relieve a painful sore throat and reduce fever. Be safe with medicines. Read and follow all instructions on the label.
    • Try an over-the-counter anesthetic throat spray or throat lozenges, which may help relieve throat pain. Do not give lozenges to children younger than age 4. If your child is younger than age 2, ask your doctor if you can give your child numbing medicines.
  • Protect others.

    For the first 24 hours after you start taking an antibiotic, you are still contagious so stay home. You can avoid passing the strep throat infection to others and reinfecting yourself by:

    • Avoiding sneezing or coughing on others.
    • Washing your hands often.
    • Using tissues you can throw away, not handkerchiefs.

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Credits

Current as of: September 27, 2023

Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

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