Strep throat is a bacterial infection caused by group A streptococcus bacteria, a common but potentially serious illness. While most sore throats are viral, strep requires diagnosis and treatment with antibiotics to prevent complications. In the United States, roughly 20,000 to 27,000 invasive strep cases occur annually, leading to 1,800 to 2,400 deaths – highlighting why accurate testing is critical.
Understanding Strep Throat Symptoms
Strep throat typically develops two to five days after exposure, spreading through respiratory droplets from coughing or sneezing. Common symptoms include:
- Sudden onset sore throat: Pain that appears quickly and intensifies.
- Fever: Often high, particularly on the second day.
- Red throat: May show white patches or pus.
- Small red spots: Visible at the back of the mouth.
- Swollen lymph nodes: Tender to the touch in the neck.
- Painful swallowing: Difficulty and discomfort with each swallow.
- Additional symptoms (especially in children): Chills, body aches, nausea, abdominal pain.
If strep progresses to scarlet fever, look for a sandpaper-like rash, bright red skin folds, and a swollen, red tongue.
Why Testing Matters: Differentiating Strep from Viral Infections
Distinguishing strep from a viral sore throat is difficult without testing. Doctors cannot reliably diagnose strep by visual inspection alone; white patches or redness alone don’t confirm the infection. According to infectious disease specialists, up to 90% of sore throats in adults are viral, not strep.
If you have additional symptoms like a runny nose, cough, hoarseness, or pink eye, it’s likely a virus. However, a rapid onset of fever, sore throat, and swollen lymph nodes without these viral symptoms increases the possibility of strep.
Diagnosis and Testing Procedures
A doctor will assess symptoms, check your temperature, examine your throat, and feel for swollen lymph nodes. If strep is suspected, a throat swab is essential. There are two primary testing methods:
- Rapid strep test: Provides results in minutes, but may miss some cases.
- Lab culture test: More accurate but takes several days for results.
If the rapid test is negative, a lab culture should be performed to confirm the absence of infection definitively. Prompt antibiotic treatment is crucial once strep is confirmed.
When to Seek Medical Attention
See a doctor immediately if you or your child experience:
- A sore throat lasting over 48 hours.
- Fever above 101°F persisting for more than two days.
- Difficulty swallowing or breathing.
- A rash accompanying the sore throat.
Ignoring strep throat can lead to serious complications, including toxic shock, flesh-eating disease, and even death in rare cases.
The key takeaway: Most sore throats are viral, but strep throat requires specific testing and antibiotic treatment. Accurate diagnosis prevents unnecessary antibiotic use for viral infections while ensuring that bacterial strep is treated promptly to avoid complications.
