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How to Tell the Difference Between a Sore Throat and Strep



Now that cold and flu season has officially arrived, people become a little more keenly aware of every cough, sniffle, or sneeze as potentially signaling the beginning of something worse. When it comes to having a sore throat, few winters pass without experiencing some kind of a scratchy, raw feeling located in the back of the throat.

A sore throat can have a number of harmless causes, such as developing a mild cold, the result of seasonal allergies, or just the harsh bite of breathing in the cold winter air. However, in some cases, a sore throat may indicate strep, a nasty bacterial infection that can become dangerous when left untreated. While your doctor can perform a throat culture to determine whether a sore throat is actually strep, an unnecessary trip to the doctor can further strain an already tight budget. Fortunately, there are signs that can provide you with the clues needed to determine whether you have a simple scratch or strep.

Spot Check

There’s a reason your doctor asks you to open wide and say “Ahhh.” Taking a quick glance at the back of the throat can help to reveal important information about what’s causing your discomfort. Strep will usually produce tiny white patches that appear on the tonsils and throat. Your tonsils may also become red or swollen, and pus may develop in the back of the throat. If you notice any white nodules or swelling, you’ll need to schedule an appointment to see a doctor.

Need Tissue?

Coughing, sneezing, and experiencing a postnasal drip can all make your throat feel like its been rubbed down with a Brillo Pad, but these symptoms rarely have anything to do with strep. If you experience cold-like symptoms in addition to a sore throat, breath easy (if possible) as a cold virus is probably to blame.


Even though some cold strains cause a fever, they are generally of the low-grade variety. If you experience a fever over 101 degrees Fahrenheit, the likelihood of having strep becomes much higher. However, strep can develop with little to no fever; so don’t rely solely on your temperature to determine whether you have strep.

Swollen Lymph Nodes

The role of the lymph nodes in your body is to trap and destroy germs. When the lymph nodes in the neck become tender and swollen it could be a sign of strep. As a general rule, whenever a part of the body becomes infected, the lymph nodes nearest the infection become swollen as they go about eradicating the infection.

On a scale of 1 to 10…

While the pain from a sore throat caused by a cold can lead to plenty of discomforts, it generally fades after a few days. Conversely, the pain caused by strep can make eating, drinking, and even talking extremely difficult, and can last for a week, while becoming progressively worse. If you find yourself unable to eat, nauseous, or experience pain in the abdomen or head, your sore throat probably has more to do with strep than a simple head cold.

Bacterial Infection

The most important reason to distinguish whether the cause of your sore throat is a cold or strep is that Group A Streptococcus, a bacterial infection, causes strep while a virus generally causes a cold. Unlike a virus, antibiotics can treat a bacterial infection, which could lessen the severity and duration of an illness. Without antibiotic treatment, a strep infection could cause complications that affect the heart and other major organs. Even though rare, this type of infection can lead to the development of a serious illness.