Common Sore Throat or Strep?

We all know that raw, scratchy feeling in the back of the throat. The cause may be as simple as dry winter air, seasonal allergies, or a developing cold. But sometimes the culprit is strep, a bacterial infection that can be dangerous if untreated. Only your health care provider can make a firm diagnosis, but there are signs that may provide clues that you have strep rather than a common sore throat.

Are There Unusual Spots?

Mom has the right idea when she asks her kids to say "Ahhh." Looking inside the throat can reveal important clues about what's causing the pain. Strep often produces white patches in the throat and on the tonsils, as well as red, swollen tonsils. Pus may be seen in the back of the throat.

Are There Cold Symptoms?

Coughing and postnasal drip can make your throat feel bad, but these symptoms are less likely to occur with strep. When congestion, runny nose, and other cold symptoms accompany a sore throat, a cold virus is usually to blame.

How High Is the Fever?

Colds sometimes cause a fever, but it's generally low grade. A sore throat with a fever over 101 degrees Fahrenheit raises the likelihood of strep. However, strep can be present even with little or no fever.

Are the Lymph Nodes Swollen?

Strep throat may cause the lymph nodes in the neck to become swollen and tender. The lymph nodes are responsible for trapping and destroying germs. When part of the body is infected, the nearest lymph nodes tend to swell as they carry out their job.

How Much Does It Hurt?

A sore throat caused by a cold can be plenty painful, but it usually goes away after a couple of days. Strep throat tends to be more severe and persistent -- the pain may be so bad, it's hard to swallow. In some cases, strep may cause nausea, a lack of appetite, or pain in the head and abdomen.

Is There a Rash?

A less common sign of strep infection is a rash that appears on the neck and chest, eventually spreading to the rest of the body. When this rough, sandpaper-like rash develops, the infection is known as scarlet fever. Although the full body rash may be alarming, it will start to fade after a few days. Antibiotic treatment can help protect against complications of strep infection.

Strep Is a Bacterial Infection

The reason it's so important to distinguish between strep and a common sore throat is that strep is caused by a bacterial infection -- Group A Streptococcus -- and a simple sore throat is usually caused by a virus. Antibiotic treatment may lessen symptoms and duration of illness. It will also decrease the chance for complications. Without antibiotics, a strep infection may lead to complications that affect the heart or other organs. Though rare, this can cause serious illness.

Colds & Antibiotics: Just Say No

You can't get rid of a cold-caused sore throat with antibiotics. That's because colds are caused by viruses, and antibiotics only work against bacteria. Besides, taking antibiotics unnecessarily can contribute to the growing problem of microbial resistance. When bacteria are frequently exposed to antibiotics, they may become "superbugs" that can't be treated with standard medications.

Rapid Strep Test

To decide whether a sore throat is caused by strep or a cold, your health care provider may use a rapid strep test. The results are ready in five to 10 minutes, but the test doesn't pick up all cases of strep. If the results are negative, your doctor may send a throat culture to the lab. This takes a couple days to complete.

Antibiotics for Strep

If you're diagnosed with strep, your doctor may prescribe 10 days of antibiotics or give you an antibiotic shot. You'll probably feel better in a day or two, but it's vital to take the entire course of antibiotics anyway -- otherwise some of the bacteria may survive. Remember, your strep can still be contagious until 24 hours of taking antibiotics, so wash your hands often, and don't share utensils. And be sure to throw away your toothbrush after you've had strep.

Home Care for Sore Throats

Whether you've got a sore throat from strep or a cold, there are steps you can take at home to relieve the ache. One trick for soothing a sore throat is a saltwater gargle. Try mixing a teaspoon of salt into a glass of water to make this easy remedy, which can help keep the throat moist and reduce that raw, scratchy feeling.

Humidifier or Vaporizer

Breathing in steam from a humidifier or vaporizer can keep a sore throat moist and cut down on pain. You can get the same result by leaning over a sink with hot running water. Drape a towel over your head to trap the steam and breathe deeply. Try this for five to 10 minutes several times a day.

Humidifier or Vaporizer

Try placing a warm heating pad against the outside of your throat. Or make your own warm compress by wetting a towel with hot water. This may be especially soothing if you have tender lymph nodes in the neck.

Soothing Foods

If you need an excuse to eat ice cream, a sore throat is a good one. The cold has a numbing effect, and the creamy texture makes it easy to swallow. This comfort food is also great for cheering up young (and not-so-young) patients. Other soothing foods include milk shakes, gelatin, and hot soup. With severe sore throats, it's best to avoid crunchy or spicy foods.

Hydration

Since fever and painful swallowing can lead to dehydration, it's important to increase your intake of fluids to combat it. Water and ginger ale are good choices. Avoid citrus drinks which can irritate an inflamed throat.

Pain Relievers

Over-the-counter pain relievers, like acetaminophen, ibuprofen, or naproxen, can temporarily dull the pain of a sore throat. (Do not give aspirin to children and teenagers because of the risk of the rare but potentially fatal Reye's syndrome.)

Sore Throat Sprays and Lozenges

You can also soothe a painful sore throat with a numbing spray or lozenge. Sucking on ice chips can also bring some relief. You can even carry a travel-size throat spray in your purse or briefcase for relief on-the-go.

Decongestants

If you have a cold -- and fluid draining from your nose is what's irritating your throat -- you might want to try a decongestant nasal spray or oral decongestant, which can dry up postnasal drip and give your throat some relief. People with certain medical conditions and people taking certain medications may need to avoid the use of decongestants.

Persistent Sore Throat

If a sore throat lasts over a week or gets worse, check with your doctor again, even if an initial strep test came back negative. It's possible for a throat swab to miss bacteria, and you may need to be retested. A persistent sore throat could also be a sign of acid reflux, mononucleosis, or another condition. In rare cases, a sexually transmitted disease may be to blame.

More Reading on Sore Throats

• Sore Throat (Pharyngitis)
• Strep Throat
• Cold, Flu, Allergy Treatments
• Common Cold
• Streptococcal Infections
• Swollen Lymph Nodes