6 Strep Throat Signs to Never Ignore

Updated: Mar. 28, 2022

Your throat may be on fire, but it may or may not be strep throat. Here are the strep throat symptoms you should know.

Jar of cotton swabs and throat sticks at a doctor's office.
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What is strep throat?

The painful sore throat known as strep throat occurs due to an infection with group A strep bacteria, according to the Centers for Disease Control and Prevention (CDC). It most commonly affects the tonsils—lymph organs that typically help fight infection, according to Jason Abramowitz, MD, a physician at ENT and Allergy Associates in New York. The infection can also settle in the walls of the throat if you no longer have tonsils, he says, though that’s less likely. Check out these 12 signs your common cold could be something much worse.

Little girl resting her head on her mother's lap.

You’re (really) young—or live with someone who is

Age is one criterion doctors use to diagnose strep. Most often, strep strikes kids between age three and 14. “As we get older, our tonsils are supposed to shrink. When they’re smaller, they’re less prone to the inflammation that can open them up to a bacterial infection,” says Dr. Abramowitz. Caretakers for children (like parents of school-age kids) are also at risk. Another group the infection is common in, he says, is older adults. Watch for these strep throat symptoms below.

You have a sore throat and fever

It’s common to get a sore throat when you have a cold, but a sign of a sore throat from strep is a pain that’s worse than normal and occurs in combination with a fever (a temperature over 100.4º F.), says Dr. Abramowitz. It may also be painful to swallow, and “more often than not, a sore throat will come on quickly,” he says. (Here are the signs your common cold may be something else.)

Doctor examining little girl's mouth and tonsils at the doctor's office.

You’re seeing white stuff on your tonsils

Common among strep throat signs is seeing pus on your tonsils because of the infection. Just note that some people with large tonsils notice white spots on their tonsils when they’re inflamed, and that could indicate a tonsil stone (a built-up bacteria and debris). “Many times, a doctor may give antibiotics thinking that it’s pus—when it’s not,” says Dr. Abramowitz. It’s a good idea to get checked by a specialist if you’re not getting better. If you have strep, you may also notice tiny red spots on the roof of your mouth, according to the CDC. Find out 6 times you should say no to antibiotics—and when to say yes.

Woman with touching her neck with a sore throat.

You can feel swollen glands

Touch your neck—you may notice swollen lymph nodes, which may be one sign that you have a bacterial infection. “These tend to be painful, and they feel like small, little rubbery balls,” says Dr. Abramowitz. Of course, some people don’t notice these at all. Swollen lymph nodes are just one of the possible strep throat symptoms; if yours aren’t swollen, it doesn’t mean it’s not strep.

Woman in a blue cardigan coughing into a tissue.
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There’s no cough

A cough originates farther down in your throat, while strep happens closer to the top—so don’t count this among the strep throat symptoms. “If someone is coughing, it indicates they have mucus dripping down the back of the nose. The irritation is occurring further down in the throat, which is causing the cough,” says Dr. Abramowitz. You also won’t have symptoms that are more viral in nature, like pink eye or a runny nose. If you’re battling a persistent cough, check out these 10 possible reasons it’s not going away.

Man in a cardigan looking fatigued.

You’re not getting better

Pay attention to strep throat signs that stick around for a while and don’t ease up. “Viruses typically don’t last longer than a week. When symptoms persist for seven to 10 days, we start to think that other things are involved, like a bacterial infection,” says Dr. Abramowitz. Certainly, a sore throat is not usually something to worry about, but it pays to know these 6 early throat cancer symptoms.

Blister packs with pills and capsules.
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Do you have strep?

If you suspect strep, get checked out by your doctor. If you have strep throat symptoms, you will get a rapid strep test, in which your doctor takes a throat swab; the results appear in minutes. If the results are positive, you’ll likely receive antibiotics. If the results are negative, you still may not be in the clear. Your doctor can also take a throat culture, which allows strep to grow on the swab. You’ll get a call in a day or two with the results, says Dr. Abramowitz.

Doctor checking patient's heartbeat with a stethoscope at a hospital.
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Yes, you do need to go to the doc

Although strep throat is generally mild, children and teens can develop rheumatic fever (and eventually rheumatic heart disease) if it’s left untreated, the CDC notes. This condition can harm the heart, joints, brain, and skin. The good news is that once you’re diagnosed and treated, you’ll likely recover quickly. “You usually feel better after 24 to 48 hours of being on antibiotics,” says Dr. Abramowitz. Once you’re fever-free for 24 hours, it’s safe to head back to school or work without worrying about infecting others. Next, make sure you know these 6 clear symptoms of the flu.