October 2022

Strep throat is a bacterial infection of the throat and tonsils. It‘s more common than you’d think. The CDC estimates that up to 30% of kids with a sore throat have strep — and about 10% of adults with a sore throat have strep.

A sore throat may not sound all that serious, but strep throat can lead to serious complications if left untreated. Learn more about the symptoms of strep, as well as getting tested and treated for it.

Strep throat symptoms

A sore throat isn’t the only warning sign that you or your child might have strep. Other signs and symptoms include

• Fever.
• Pain when swallowing.
• Tiny red spots on the roof of the mouth.
• Red and swollen tonsils.
• Swollen lymph nodes in your neck.

Because many cold viruses can also cause sore throats, it’s helpful to also know the signs that it’s likely a virus and not strep throat. These include

• Runny nose.
• Cough.
• Hoarseness.
• Pink eye.

The dangers of not treating strep throat

Failing to treat strep throat can lead to multiple potential complications. These include ear, sinus, and tonsil infections.

There are also two serious complications that can occur — not from the bacterial infection itself, but from the immune system’s fight against it.

Rheumatic fever: This inflammatory disease can infect the heart, brain, joints, and skin. This disease can occur when someone has strep throat or scarlet fever that is not treated properly. Rheumatic fever can lead to serious damage to the heart, including rheumatic heart disease, which can be fatal. Rheumatic fever is far more likely to affect children and teens. Adults are typically not at risk of rheumatic fever after getting strep throat.

Post-streptococcal glomerulonephritis (PSGN): This rare but serious kidney disease can develop one to two weeks after an untreated strep throat infection. Most people who develop PSGN recover without long-term problems. While rare, it can result in long-term kidney damage — including kidney failure. Adults are more likely than children to experience serious complications from PSGN.

How to get tested for strep

If you or your doctor suspect that you have strep throat, there are two types of tests you can get: a rapid test and a throat culture. Both tests involve swabbing the throat to look for strep bacteria.

Rapid strep test: A rapid strep test can tell you — usually within 10 to 15 minutes — if group A strep is causing your illness. Your doctor can often perform a rapid test in their office. Your local pharmacy may also offer rapid tests — or sell them for you to do at home. If the test is positive, doctors can prescribe antibiotics immediately.

Throat culture: Unfortunately, there are some false negatives with rapid testing. If your rapid test is negative but your doctor strongly suspects strep (based on your symptoms), they may recommend a follow-up throat culture. Throat cultures typically take one to two days to yield results, but they’re better able to detect strep bacteria than a rapid test.

How to treat strep throat

Fortunately, strep throat is relatively easy to treat with a course of antibiotics. The go-to antibiotics for strep throat are penicillin and amoxicillin. For those with a penicillin allergy, there are other antibiotics your doctor can prescribe.

Antibiotics can help you feel better more quickly and can decrease your chances of spreading strep to others. (A quicker recovery means you’re not infectious for as long.) More importantly, antibiotics can prevent serious complications such as rheumatic fever.

If your sore throat is the result of a viral infection, antibiotics won’t help. That’s why your doctor will want to confirm an infection by a rapid test or throat culture before prescribing you any medication.