Strep Throat - Symptoms

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What are the signs and symptoms of strep throat?

Signs of strep throat are not unique - indeed many viral infections (which cause the large majority of sore throats) can have identical signs and symptoms as a GAS infection. Typically, an older child and adolescent will have several core symptoms:

  • Fever (generally 102 F [38.88 C] and higher)
  • Sore throat (may vary from mild to moderate in severity)
  • Headache
  • Upset stomach with nausea occasionally severe enough to cause mild vomiting

Of note is the fact that runny nose, cough, hoarse voice, muscle aches, diarrhea and oral blisters are generally not seen with a laboratory confirmed strep throat infection. These latter symptoms are more commonly indicative of a sore throat caused by a virus.

Physical examination with a strep throat infection will commonly demonstrate:

  • Redness of the soft palate, uvula (the "punching bag" structure hanging from the back of the soft palate) and tonsils
  • A purulent discharge on the tonsils (exudate)
  • Petechiae (1-2 mm bright red "dots" which represent ruptured capillaries) scattered on the soft palate
  • Enlarged and tender neck lymph nodes (also known as lymph glands), and occasionally
  • A diffuse rash over the torso and groin region. The classic description of this rash is that of "goose bumps on a moderate sunburn."

The presence of a strep infection and this specific rash is termed scarlet fever. Such a diagnosis does not imply a more severe GAS infection or imply any change in prognosis or management. The rash is not contagious. It is important to note that while most patients with strep throat will experience these signs and symptoms, not all will necessarily be present in each individual.

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See what others are saying

Comment from: andrewscore, 25-34 Male (Patient) Published: October 15

I began having a sore throat on the right side three days ago. Each day, the pain got worse and then started waking me up at night. It extended to the left side. I then began to feel feverish. I went to an urgent care clinic and the doctor immediately agreed that I almost certainly had strep. He prescribed Zithromax and also asked me to use Advil for the pain. It's been about 30 hours since my first dose. I don't have a fever anymore, but I still have plenty of throat pain.

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Comment from: Mark, 35-44 Male (Patient) Published: October 15

I started getting chills and fever on Friday. My throat got sore on Saturday and by Sunday I was in pain. I went to see the doctor on Sunday and he prescribed an antibiotic (Amoxicillin) 3 times a day for 14 days. I have never experienced this kind of throat pain before. Just to swallow my own saliva is so painful that I look forward to sleeping so that I am unaware of the pain. No pain killer was prescribed but I have been taking Tylenol 3 but it doesn't seem to be working. Interesting that as you get older the pain and soreness lasts longer and is more intense. Nothing helps, not honey, not any kind of throat lozenges (that would just burn) tea, cold drink, nothing alleviates the pain. Doctor tells me to drink warm liquids but even that hurts.

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