Symptoms of Strep Throat and Testing for It

Symptoms can be mild or severe, and often include:

• Sore throat that comes on suddenly
• Fever that may begin suddenly (often highest on the second day)
• Red appearance to the throat, sometimes with white patches or pus
• Small red spots toward the back of the roof of your mouth
• Chills and body aches
• Painful swallowing
• Tender, enlarged lymph nodes in your neck
• Headache
• Nausea or vomiting (especially in young children)
• Abdominal pain

If you also have scarlet fever — which is caused by the same bacteria as strep throat, and which can appear at the same time — you may also experience:

• A red rash that feels like sandpaper
• Bright red appearance to creases of armpits or groin
• Red, swollen tongue

What Does Strep Throat Look Like?

Some people believe that you can identify strep throat by its appearance, but this is a widespread misconception, says Nipunie S. Rajapakse, MD, a pediatric infectious disease specialist at the Mayo Clinic in Rochester, Minnesota.

“No doctor or parent can tell whether a child has strep just by looking at the throat,” she emphasizes. Even when a doctor strongly suspects that an infection is strep throat, a throat swab is necessary to confirm the diagnosis.

When strep throat is present, it typically gives a very red appearance to the throat and tonsils. There is often also a white coating on some of or all the reddened areas.

“Some people take the white coating to mean that it’s caused by strep for sure,” Dr. Rajapakse says. “But we know that with certain viruses, which are a much more common cause of sore throat in kids, you get this white coating as well.”

The red area in an infected person’s throat may extend to the roof of the mouth, sometimes appearing to “trail off” as red dots in that area.

There may also be visible areas of pus — usually bumpy-looking white or yellow secretions — on the tonsils or back of the throat.