CDC: “Sore Throat.”
Is Your Sore Throat a Cold, Strep Throat, or Tonsillitis?
Wonder if your painful sore throat is from a cold, strep throat, or tonsillitis? Here’s help with how to tell.
What’s the Difference Between a Cold, Strep Throat, and Tonsillitis?
A sore throat is often the first sign of a cold. However, a sore throat from a cold often gets better or goes away after the first day or two. Other cold symptoms such as a runny nose and congestion may follow the sore throat.
Strep throat, which is an infection due to streptococcus bacteria, is another cause of sore throats and tonsillitis. With strep throat, the sore throat is often more severe and persists.
Tonsillitis is a painful inflammation or infection of the ton sils, the tissue masses located at the back of the throat.
Is a Sore Throat With a Cold Caused by Viruses or Bacteria?
Sore throats can be caused by viruses or bacteria . The most common causes of sore throats are viruses. Viral sore throats are often accompanied by other cold symptoms that may include a runny nose, cough, red or watery eyes, and sneezing. Other causes of sore throat include smoking, pollution or irritants in the air, allergies, and dry air.
Along With a Sore Throat, What are Other Cold Symptoms?
In addition to a sore throat, other common cold symptoms include:
How Are Sore Throats With Colds Treated?
Although there is no cure for a sore throat caused by a cold virus, there are ways to help you feel more comfortable. Drinking warm liquids, gargling with warm salt water, sucking on ice chips, or taking an over-the-counter medicine may relieve symptoms of pain or fever. When you are sick with a cold, it is also important to get enough rest, eat a healthy diet, and drink plenty of fluids.
Can Medications Relieve Symptoms of a Sore Throat With a Cold?
Over-the-counter cold medications may relieve cold and sore throat symptoms. However, the benefits of these drugs are minimal. Some cold medications include:
- Pain relievers, such as acetaminophen and ibuprofen and naproxen, to relieve the aches and pains of a cold and sore throat. (Aspirin should not be given to children because of its link to Reye’s syndrome, a disorder that can cause brain damage and death.)
- Sore throat sprays and lozenges to soothe your throat and numb the throat pain temporarily. (Lozenges should not be given to young children.)
- Decongestant nasal sprays to relieve a sore throat caused by postnasal drip — nasal drainage that runs down your throat. (Be sure to stop using nasal decongestant sprays after three days, or you may have an increase in congestion when you stop them.)
Antibiotics should not be used to treat a cold virus and sore throat. Antibiotics are effective only against bacteria. They will not work on sore throats associated with colds, which are caused by viruses.
How Is Strep Throat Different From a Sore Throat With a Cold?
Stre p throat is caused by an infection of streptococcus bacteria. Strep throat spreads by having contact with an infected person’s saliva or nasal secretions. Although strep throat is more common in children ages 5 to 15, it also occurs in adults. To diagnose strep throat, your doctor can check a rapid strep test or send a throat swab to the lab for a culture. In some cases, they may be able to diagnose strep based on your reported symptoms and other signs, such as white spots in the throat area, fever, and swollen lymph nodes in the neck.
Is Strep Throat More Serious Than a Sore Throat With a Cold?
Strep throat can cause more serious illnesses, such as rheumatic fever, a disease that may harm the heart valves. That’s why it’s important to get proper medical treatment. With proper treatment, strep throat is usually cured within 10 days.
Are Strep Throat Symptoms Different From a Sore Throat With a Cold?
Strep throat symptoms are usually more severe than symptoms of a sore throat with a cold and may include the following:
- Sudden sore throat
- Loss of appetite
- Painful swallowing
- Red tonsils with white spots
- Fever
Do I Need to See My Doctor if I Think I Have Strep Throat?
The symptoms of a cold and strep throat can be very similar. If you think you have symptoms of strep throat, visit your healthcare provider. Your doctor will ask you about your symptoms and do a physical exam, and you may be given a strep test.
What Is a Strep Test for a Sore Throat?
A rapid strep test checks for streptococcus bacteria infection in the throat. The test is painless and takes very little time. The tip of a cotton swab is used to wipe the back of the throat. The swab is then tested right away. If the strep test is positive, you have strep throat. If the strep test is negative, you likely do not have strep throat. However, if there are strong signs of strep throat, your healthcare provider can do a different throat swab test that is sent to the lab to see if strep bacteria can be grown (cultured) from it. A throat culture takes a couple of days for results.
What Is the Treatment for Strep Throat?
Strep throat is treated using antibiotics, which kill the bacteria causing the infection. Antibiotics are often taken as pills or given as a shot. Penicillin and amoxicillin are common antibiotics used to treat strep throat. Other antibiotics are prescribed for people who are allergic to penicillin.
Follow your healthcare provider’s instructions for antibiotic use. Take all of the medication, even if you feel better. You should feel better within a day or two. A person with strep throat should stay home until 24 hours after starting the antibiotic.
What If My Strep Throat Isn’t Getting Better?
If your strep throat is not getting better, let your healthcare provider know right away. Do not stop taking your prescribed medicine unless your health care provider tells you to. Call your healthcare provider if these symptoms occur:
- Fever one or two days after feeling better
- Nausea or vomiting
- Earache
- Headache
- Neck stiffness
- Skin rash
- Cough
- Swollen glands
- Painful joints
- Shortness of breath
- Dark urine, rash, or chest pain (may occur three to four weeks later)
How Is Tonsillitis Different From a Sore Throat With a Cold?
Sometimes, a sore throat is caused by tonsillitis, an inflammation of the tonsils. Tonsillitis can be caused by viruses or bacteria. While the tonsils’ job is to help fight infection, the tonsils can also become infected. When they do, the result is tonsillitis and a very painful sore throat.
How Are Tonsillitis Symptoms Different From Symptoms of a Sore Throat With a Cold?
In addition to a sore throat, a cold usually causes nasal symptoms, such as runny nose or congestion. With tonsillitis, your tonsils become swollen and may have telltale white or yellow spots. Other symptoms with tonsillitis include the following:
- Bad breath
- Fever
- Voice changes because of swelling
- Painful swallowing
- Swollen lymph glands in neck
How Is a Sore Throat From Tonsillitis Treated?
If the tonsillitis infection is bacterial like strep throat, then antibiotics are given. If the tonsillitis infection is viral, antibiotics will not help. The virus must run its course for the sore throat to resolve. For either type of throat infection, the following treatment measures may help:
- Getting plenty of rest
- Drinking lots of fluid
- Eating smooth, soothing foods like gelatin, ice cream, shakes, frozen desserts, and soup
- Avoiding crunchy or spicy foods
- Using a vaporizer
- Taking over-the-counter pain relievers such as acetaminophen, naproxen, or ibuprofen. Children should not take aspirin.
If the tonsillitis infections occur repeatedly, or if the tonsils are interfering with sleep and breathing, the doctor may recommend a tonsillectomy, which is the surgical removal of the tonsils.
What would you like to learn about next?
- Tonsillitis Treatment
- Strep Throat Treatment
- Common Cold Treatment
Show Sources
CDC: “Sore Throat.”
National Heart Lung and Blood I nstitute: “Guidelines for the Diagnosis and Management of Asthma.”
American Academy of Family Physicians: “Strep Throat” and “Sore Throat: Easing the Pain of a Sore Throat.”
Do You Have Just a Sore Throat or Is It Strep?
Many different factors can cause sore throats. Viruses, bacteria such as Streptococcus pyogenes, dry air, allergies or even drainage from a runny nose can make your throat hurt.
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But not all sore throats are created equal. While allergies or a runny nose are painful nuisances, strep throat is an illness that needs a doctor’s diagnosis and treatment.
If you suspect strep throat, there are several reasons to seek treatment. For one thing, you can infect others. The bacteria that cause strep throat can also spread to other tissues, causing a more serious infection. And if you leave strep throat untreated, in rare circumstances, it can lead to a more severe illness like rheumatic fever, a potentially fatal disease that can damage your heart valves.
But how can you tell if you just have a sore throat or if you’re developing the worse condition of strep throat? Family medicine specialist Daniel Allan, MD, breaks down the difference and explains when you should make a doctor’s appointment.
Symptoms of sore throat vs. strep
Viral infections, like the common cold or flu, cause sore throats (pharyngitis). And it usually comes with other symptoms like:
- Runny nose.
- Red or watery eyes.
- Sneezing.
- Cough.
So, what’s the difference between a sore throat and strep throat? For starters, having a cough is a major symptom that sets a sore throat apart from strep.
“You do not have a cough with strep. If you’re coughing, that typically means no strep,” says Dr. Allan. “Also, when you look in the throat of a person with a sore throat caused by a cold virus, you typically do not see pus or exudate in the back of the throat.”
Colds usually take several days to develop and typically go away on their own within five to seven days. But strep throat is a bacterial infection that doesn’t always go away on its own.
If you were exposed to someone who had strep recently, that’s important information to share with your healthcare provider. Strep can be spread easily by sharing personal items with a person who’s infected, having close contact with someone who’s infected, or even through the air by sneezing or coughing. Plus, it comes with a more severe set of symptoms that include:
- Sudden sore throat.
- Red tonsils that have white spots on them.
- Pain when swallowing.
- Fever.
- Swollen neck glands.
- Loss of appetite.
- Headache.
- Abdominal pain.
Viral illnesses can have the same symptoms as strep throat, so it’s important to get a throat swab to confirm the presence of the strep bacteria in your throat if you experience any of these symptoms. A healthcare provider will dab the back of your throat with a cotton swab and the swab is then tested for the presence of the bacteria Streptococcus pyogenes.
Tips to find relief
If you have strep throat, a healthcare provider can prescribe antibiotics for treatment. But taking antibiotics for sore throats without a confirmed diagnosis of strep can create resistance to the drugs or unnecessary side effects, so getting tested for strep is important.
“Most strep will self-resolve. However, there is the risk of rheumatic fever if it’s untreated, so I would not recommend forgoing testing and treatment,” Dr. Allan warns. “If there is any concern of strep, then I would recommend getting tested.”
Antibiotic treatment for strep takes about 10 days, but treating a sore throat can be a bit less defined. There’s no one set cure for a sore throat caused by a virus and, often, the only thing you can do is wait until the virus works its way out of your system. But you can take steps to make yourself more comfortable and manage your symptoms by:
- Drinking warm liquids and plenty of water.
- Gargling with warm, salt water.
- Sucking on ice chips.
- Taking over-the-counter pain medicine like acetaminophen or ibuprofen for relief.
- Prioritizing rest.
If common winter illnesses have you guessing what ails you, it’s always good to make an appointment with a healthcare provider. And while there are home remedies that can help soothe symptoms, making an appointment with your provider’s office is key to figuring out just what might be happening with your body (and what kinds of treatments are available).
Strep Throat: All You Need to Know
Worried your sore throat may be strep throat? Doctors can do a quick test to see if a sore throat is strep throat. Antibiotics can help people with strep throat feel better faster and prevent spreading it to others.
On This Page
- Bacteria cause strep throat
- How you get strep throat
- Pain, fever, but no cough is common
- Some people are at increased risk
- A simple test gives fast results
- Antibiotics are used for treatment
- Not everyone needs antibiotics
- Serious complications are not common
- Protect yourself and others
Bacteria cause strep throat
Viruses cause most sore throats. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep).
How you get strep throat
Group A strep bacteria are very contagious. Generally, people spread the bacteria to others through
- Respiratory droplets
- Direct contact
Rarely, people can spread group A strep bacteria through food that is not handled properly (visit CDC’s food safety page).
It usually takes two to five days for someone exposed to group A strep bacteria to become ill with strep throat.
Respiratory droplets
Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing, which creates respiratory droplets that contain the bacteria.
People can get sick if they:
- Breathe in respiratory droplets that contain the bacteria
- Touch something with those droplets on it and then touch their mouth or nose
- Drink from the same glass or eat from the same plate as a person infected with group A strep bacteria
Direct contact
People can also spread group A strep bacteria from infected sores on their skin. Other people can get sick if they:
- Touch sores on the skin caused by group A strep bacteria (impetigo) or come into contact with fluid from the sores
It is important to know that some infected people do not have symptoms or seem sick. People sick with strep throat are much more contagious than those who do not have symptoms.
A sore throat that starts quickly, pain with swallowing, and fever are some of the common signs and symptoms of strep throat.
Pain, fever, but no cough is common
In general, strep throat is a mild infection, but it can be very painful. The most common symptoms of strep throat include:
- Sore throat that can start very quickly
- Pain when swallowing
- Fever
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Petechiae — pronounced pi-TEE-kee-eye — on the soft or hard palate (tiny, red spots on the roof of the mouth)
- Swollen lymph nodes in the front of the neck
Other symptoms may include a headache, stomach pain, nausea, or vomiting — especially in children. Someone with strep throat may also have a rash; it is known as scarlet fever.
Some symptoms suggest a viral cause rather than group A strep
The following symptoms suggest a virus is the cause of the illness instead of strep throat:
- Cough
- Runny nose
- Hoarseness (changes in your voice that make it sound breathy, raspy, or strained)
- Conjunctivitis (pink eye)
Strep throat: More common in children
- Up to 3 in 10 children with a sore throat have strep throat
- About 1 in 10 adults with a sore throat has strep throat
Some people are at increased risk
Anyone can get strep throat, but there are some factors that can increase the risk of getting this common infection.
Age
Strep throat is more common in children than adults. It is most common in children 5 through 15 years old. It is very rare in children younger than 3 years old.
Adults who are at increased risk for strep throat include:
- Parents of school-aged children
- Adults who are often in contact with children
Group settings
Close contact with another person with strep throat is the most common risk factor for illness. For example, if someone has strep throat, the bacteria often spread to other people in their household.
Infectious illnesses tend to spread wherever large groups of people gather. Crowded settings can increase the risk of getting a group A strep infection. These settings include:
- Schools
- Daycare centers
- Military training facilities
A simple test gives fast results
A doctor will determine what type of illness you have by asking about symptoms and doing a physical exam. If they think you might have strep throat, they will swab your throat to test for strep throat. There are two types of tests for strep throat: a rapid strep test and throat culture.
Rapid strep test
A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep bacteria are causing the illness.
- If the test is positive, doctors can prescribe antibiotics.
- If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab.
Throat culture
A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses.
Culture is important to use in children and teens since they can get rheumatic fever from an untreated strep throat infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following a strep throat infection.
Antibiotics are used for treatment
Doctors treat strep throat with antibiotics. Benefits of antibiotics include:
- Decreasing how long someone is sick
- Decreasing symptoms (feeling better)
- Preventing the bacteria from spreading to others
- Preventing serious complications like rheumatic fever
Someone with strep throat should start feeling better in just a day or two after starting antibiotics. Call the doctor if you or your child are not feeling better after taking antibiotics for 48 hours.
When to return to work, school after illness
People with strep throat should stay home from work, school, or daycare until they:
- No longer have a fever
- Have taken antibiotics for at least 12 hours
Antibiotic dos and don’ts
- Do take the prescription exactly as the doctor says to.
- Don’t stop taking the medicine, even if you or your child feels better, unless the doctor says to stop.
You can find more guidance on taking antibiotics on CDC’s Antibiotic Do’s & Don’ts Page.
Not everyone needs antibiotics
Someone who tests positive for strep throat but has no symptoms (called a “carrier”) usually does not need antibiotics. They are less likely to spread the bacteria to others and very unlikely to get complications.
If a carrier gets a sore throat illness caused by a virus, the rapid strep test can be positive. In these cases, it can be hard to know what is causing the sore throat.
If someone keeps getting a sore throat after taking the right antibiotics, they may be a strep carrier and have a viral throat infection. Talk to a doctor if you think you or your child may be a strep carrier.
Serious complications are not common
Complications can occur after a strep throat infection. This can happen if the bacteria spread to other parts of the body.
Complications can include:
- Abscesses (pockets of pus) around the tonsils or in the neck
- Swollen lymph nodes in the neck
- Sinus infections
- Ear infections
- Rheumatic fever (a disease that can affect the heart, joints, brain, and skin)
- Post-streptococcal glomerulonephritis (a kidney disease)
Wash your hands often to help prevent germs from spreading.
Protect yourself and others
People can get strep throat more than once. Having strep throat does not protect someone from getting it again in the future. While there is no vaccine to prevent strep throat, there are things people can do to protect themselves and others.
Good hygiene
The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.
To prevent group A strep infections, you should:
- Cover your mouth and nose with a tissue when you cough or sneeze.
- Put your used tissue in the waste basket.
- Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
- Wash your hands often with soap and water for at least 20 seconds.
- Use an alcohol-based hand rub if soap and water are not available.
You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.
Antibiotics
Antibiotics help prevent someone with strep throat from spreading the bacteria to others.
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