Strep Throat: Signs and Treatment

Medically Reviewed by Poonam Sachdev on May 16, 2024
9 min read

Strep throat is an infection of the throat and tonsils caused by a bacteria called group A streptococcus, which is also known as Streptococcus pyogenes. This bacteria lives in the nose and throat. You can get the infection from someone who is carrying strep A bacteria or is sick from it.

Anyone can get strep throat, but it's most common in children and teens. 

Strep throat vs. sore throat

sore throat is the main sign you or your child has strep. However, allergies, dry air, sinus drainage, colds, and other viruses can cause a sore throat too.

Signs that the infection might be viral rather than caused by strep bacteria include:

  • Cough
  • Runny nose
  • Hoarse voice
  • Pinkeye (also called conjunctivitis)

Strep throat typically appears as pus or inflammation at the back of your throat. While you can usually treat sore throats caused by something other than strep on your own, it's important to see a doctor if you think you have strep throat.

Viral infections cause most sore throats, but strep throat is a bacterial infection. 

Is strep throat contagious?

The bacteria that cause strep throat pass easily from person to person through close contact. Strep throat spreads when someone who has the infection coughs or sneezes, spraying droplets filled with bacteria into the air.

You can get strep throat if you:

  • Breathe in the air with droplets filled with bacteria
  • Touch something these droplets land on, such as a doorknob or table, and then rub your eyes, nose, or mouth
  • Share personal items such as a fork or spoon, glass, or toothbrush with someone who is sick
  • Kiss a person who has it

Strep throat contagious period

When you get infected with strep throat, you typically start to show symptoms about 2-5 days after you were exposed to the bacteria.

You can stay contagious for up to a month if you don't get treated. Antibiotics can prevent the infection from spreading. People who take antibiotics stop being contagious after about 24 hours.

Strep throat without tonsils

Strep throat typically impacts your tonsils and throat. You can still get strep throat if you don't have tonsils, but you will probably get it less frequently and your symptoms may be milder.

Can you get strep throat twice?

Yes. You are not immune to getting strep throat again if you've had it before, and there is no vaccine to prevent it.

With strep, the sore throat comes on quickly and is more likely to cause these other symptoms. Call your doctor if you or a child in your care has the following:

  • A fever of 101 F or higher
  • Red, swollen tonsils
  • Pain when you swallow
  • Swollen and/or tender lymph nodes at the front of your neck
  • White patches in the throat
  • Tiny red spots on the roof of the mouth (called petechiae)
  • Appetite loss
  • Stomachache
  • Headache
  • Body aches
  • Nausea or vomiting
  • Loss of appetite
  • Rash

White spots on the throat

If you have strep throat, the telltale white patches, streaks, or spots on your throat are pus and indicate infection.

Strep skin rash

Scarlet fever, which sometimes develops in people with strep throat, causes a bright red rash that spreads over most of the body. Scarlet fever mostly affects children between the ages of 5 and 15. Once considered serious, it's now easily treated with antibiotics. However, if left untreated, scarlet fever may damage the heart, kidneys, or other organs.

Strep throat and cough

Having a cough with your sore throat is a key way doctors know you don't have strep throat. If you have a cough with your sore throat, it's most likely a viral condition rather than strep throat, a bacterial infection.

To see whether you have strep throat, contact your health care professional. They will ask about your or your child's symptoms. The only sure way to tell strep from viruses that cause a sore throat is to do a test.

Strep throat test

There are two kinds of strep throat tests:

Rapid strep test. It can identify a case in just a few minutes. The doctor will gently hold down your or your child's tongue with a depressor. Then, they will swipe a cotton swab around the back of the throat.

You'll get the results in 20 minutes or less. If the test is positive, which means strep is there, the doctor may prescribe antibiotics to treat it.

If the test is negative, that means they didn't find strep bacteria. Your doctor might send the sample to a lab for a follow-up test that takes longer.

A rapid strep test can be positive even if you have a sore throat that's caused by a virus. It can be difficult to tell what's causing the sore throat in that situation because you're carrying the bacteria and a virus. If you keep getting a sore throat after taking antibiotics, you could have a viral throat infection and be a strep throat carrier. You might be less likely to spread it to other people, though.

Throat culture. The doctor will rub a swab over the throat and tonsils to be sent to the lab. If you or your child has strep throat, the streptococci bacteria will grow in it.

It usually takes about 2 days to get results from a throat culture. It can confirm whether it's strep throat or not.

Your doctor may prescribe antibiotics to kill the bacteria that cause the infection. Most treatments last about 10 days. The medicine can make symptoms go away faster and help prevent complications.

If you or your child has a positive test but no symptoms, you're probably just a carrier. In that case, you're less likely to spread the bacteria to others and unlikely to have complications. So, you probably won't need antibiotics. Your doctor can let you know if you need them or not.

If the strep test is negative, a virus likely caused the sore throat. Antibiotics won't be needed because these medications don't kill viruses.

You can take medications to ease the pain of strep throat and lower fever, including over-the-counter medicines such as ibuprofen or acetaminophen. Don't give aspirin to children or teens. It can cause a rare but dangerous condition called Reye’s syndrome.

Antibiotics for strep throat

The antibiotics penicillin and amoxicillin are the common treatment for strep throat. If you or your child are allergic to penicillin, then a class of drugs called cephalosporins (such as cephalexin and cefadroxil) may be used. Most oral antibiotics are usually taken for 10 days. There is also the option of a one-dose penicillin shot.

Make sure you or your child takes all of the doses. Stopping the medicine too early can leave some bacteria alive. These can make you or your child sick again. Be sure to tell the doctor if you or your child is allergic to any type of antibiotics.

Strep throat treatment without antibiotics

Treating strep throat with antibiotics is strongly recommended, as they can reduce the severity of your illness, limit contagiousness, and prevent complications. Not taking antibiotics, or failing to take all of them as prescribed, can lead to serious complications.

How long does strep throat last?

With antibiotics, you or your child should feel better within a couple of days. Call your doctor if that's not the case. After treatment, you should be less contagious in about a day. If you don't get treated with antibiotics, you can remain contagious for several weeks.

There are several things you can do at home to lessen pain and make you feel more comfortable:

  • Gargle with a mixture of 1/4 teaspoon of salt and 8 ounces of warm water.
  • Suck on a throat lozenge or a piece of hard candy. But don't give small pieces of candy to children younger than 4.
  • Throw out your toothbrush and use a new one.
  • Drink warm liquids such as tea and broth, and drink plenty of water to prevent dehydration .
  • Suck on something cold such as an ice pop or ice chips.
  • Choose soft foods that are easy to swallow such as soups, applesauce, or oatmeal. Pass on orange juice and other drinks that have a lot of acid. They'll sting.
  • Honey can help ease pain and inflammation.
  • Use a humidifier and/or saline nasal sprays to keep your airways moist, which can help you feel more comfortable.
  • Get lots of rest so your body can recover from the infection.

The best way to avoid strep is to stay away from anyone who looks or sounds sick. Signs of strep throat can include:

  • Sore throat
  • Swollen glands
  • Fever
  • Nausea or vomiting
  • Rash

Try not to share any personal items with someone who is sick. These include:

  • Cups and plates
  • Knives, forks, and spoons
  • Toothbrushes
  • Food and drinks

If you have strep, here are some things you or your child can do to avoid getting sick again:

  • Take all the medicine your doctor prescribed, even if you start to feel better. Some bacteria may live and rebound if you stop the medication too soon.
  • Once you've been on antibiotics for 2-3 days, throw out your old toothbrush and get a new one.
  • Stay out of work or school for at least 24 hours after you start taking an antibiotic.
  • Wash your hands and your children's hands often. Or use an alcohol-based hand sanitizer several times a day. Always clean your hands before you eat and after you use the bathroom.
  • Ask your children to cover their mouths with a tissue or sleeve whenever they cough or sneeze.

Strep complications are rare today, thanks to better diagnosis and treatment. But untreated strep throat can cause serious diseases, such as:

  • The infection spreading to the tonsils, sinuses, middle ear, the mastoid bone behind the ear (mastoiditis), skin, or blood
  • A peritonsillar abscess — a collection of pus around the tonsils or behind the throat that can be extremely painful

Other strep complications involve an inflammatory response in different parts of your body, including:

  • Scarlet fever, a red rash that can appear as tiny, hard-to-see pinpricks or intense redness on the body that gives it its name
  • Rheumatic fever, which can damage the heart, brain, and joints
  • A kidney disease called glomerulonephritis
  • Poststreptococcal reactive arthritis, which is inflammation in your joints

Another rare complication, which is not well-understood, is a condition called PANDAS, which stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. It usually involves developing the tics and habits of obsessive-compulsive disorder (OCD) after a strep infection. Symptoms of OCD can worsen after a strep infection, too.

Guttate psoriasis, a skin condition in which teardrop scales appear on the surface of the skin, is another potential complication. The scales may be red or silver in color and can be itchy.

Strep throat is a common and easily spread bacterial infection caused by bacteria group A Streptococcus, which develops within days of exposure. Symptoms include pain when swallowing, swollen and red tonsils, and fever. Treatment with antibiotics can clear up strep throat within days, easing symptoms, and reducing the risk of strep throat's spread and complications. Left untreated, strep bacteria can travel and cause infection in other areas of your body including your sinuses, tonsils, skin, middle ear, and blood.

Can strep throat go away on its own?

Strep throat will go away on its own after about a week. However, antibiotics will resolve your symptoms faster, make you less contagious, and reduce the risk of complications.

Can adults get strep?

Strep throat most commonly occurs in children aged 5 to 15. However, anyone of any age can get strep under certain conditions. Usually, these are settings where adults come into close contact with children such as day care centers and schools, or crowded settings such as military bases, jails, or homeless shelters.

What over-the-counter medicine can I take for strep throat?

To ease your sore throat and reduce fever, take over-the-counter medicines such as ibuprofen (Advil, Motrin IB) and acetaminophen (Tylenol). However, don't give your child aspirin for fever, as this has been linked to Reye's syndrome, a rare but potentially life-threatening condition for children and teenagers.

Can I get rid of strep throat overnight?

No. But a course of antibiotics should help you feel better within 48 hours. Until then, ease your sore throat with pain-relieving over-the-counter medicines.

What should you eat when you have strep throat?

To ease swallowing pain, drink plenty of water and eat easy-to-swallow foods such as broth, applesauce, yogurt, and soft-cooked eggs. Eating cold foods such as popsicles, sherbet, or frozen yogurt might also soothe your throat. Avoid spicy or acidic foods.