Test Your Knowledge

Signs and symptoms of strep throat usually appear within five days of being exposed to the bacteria that cause the condition. The first sign of strep throat is often a sore throat. Although sore throat can also indicate a viral infection, a sore throat associated with strep tends to last longer than in the case of a cold or the flu. In addition, symptoms of strep throat are generally more severe and begin more suddenly than viral infections of the throat.

Common symptoms of strep throat in people age 4 years and older include:

• Sudden, high fever (higher than 102 degrees Fahrenheit or 38.9 degrees Celsius)
  
  
• Swollen lymph nodes (glands) in the neck
  
  
• Red, swollen tonsils (tissue located inside the mouth, at either side of the throat)
  
  
• White spots or coating of the tonsils (may also be yellow or gray in color)
  
  
• Abdominal pain
  
  
• Headache
  
  
• Difficulty swallowing
  
  
• Loss of appetite
  
  
• Nausea and vomiting
  
  
• Rash
  
  
• Weakness

Symptoms may vary when strep throat occurs in young children. Signs of strep throat in infants include:

• Low-grade fever (under 102 degrees Fahrenheit or 38.9 degrees Celsius)
  
  
• Thick and bloody nasal discharge

Signs of strep throat in toddlers include:

• Low-grade fever (under 102 degrees Fahrenheit or 38.9 degrees Celsius)
  
  
• Thick and bloody nasal discharge
  
  
• Increased irritability
  
  
• Sleeplessness
  
  
• Loss of appetite
  
  
• Swollen neck glands

The presence of any of the following may indicate a viral infection rather than strep throat:

• Runny nose
  
  
• Coughing
  
  
• Hoarseness
  
  
• Red eyes

Some people do not display the symptoms of the infection but nonetheless are carriers of the bacteria. In other cases, symptoms of strep may be especially severe and indicate more serious illness. Prolonged or high fever, breathing problems or significant difficulty swallowing are signs of strep that indicate a medical emergency that requires immediate attention.

Untreated strep throat can spread to other areas of the body and lead to serious medical conditions. However, these complications are rare in the United States since prompt and effective treatment is delivered in most cases of strep throat. These complications include:

• Rheumatic fever. A severe inflammatory disease that causes joint pain and may cause permanent heart problems. Rheumatic fever occurs approximately 18 days after an episode of strep throat, according to the National Institutes of Health (NIH). It most often affects children.
  
  
• Glomerulonephritis. Inflammation of the kidneys that may lead to kidney failure. This condition may occur after an untreated case of strep throat, although it occurs more often after a strep infection of the skin.
  
  
• Sydenham chorea. Sometimes follows rheumatic fever. This disorder involves uncontrolled, jerking movements of the muscles in the torso, arms and legs.

If a person develops a skin rash shortly (often 24 to 48 hours) after the strep throat symptoms begin, it may indicate scarlet fever. A rash accompanied by swelling of the joints or shortness of breath after a strep infection may indicate rheumatic fever. People who notice these symptoms should seek immediate medical attention.