Symptoms of Strep Throat

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Strep throat, a bacterial infection, has a number of classic signs and symptoms, such as sore throat and swelling, enlarged tonsils, bad breath, fever, chills, headaches, and decreased appetite. All of these can occur with bacterial or viral infections, so the signs and symptoms alone cannot be used to diagnose strep throat.

If you have signs and symptoms of step throat, your doctor will determine if strep testing is necessary. Read more to learn about the symptoms, signs, and complications of strep throat and when to get emergency medical attention.

strep throat symptoms
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Frequent Symptoms

It will take a few days after you are exposed to the bacteria before you begin to feel sick. The time between exposure and the development of symptoms is called the incubation period.

Strep throat typically has an incubation period of 2-5 days, and you can begin to be contagious during this timeframe.

The most common signs and symptoms of strep throat include:

  • Sore throat, especially when swallowing
  • Fever and chills 
  • Headaches
  • Fatigue and lack of energy
  • Decreased appetite
  • Enlarged lymph nodes, which may feel like lumps on the sides of your neck or in your armpits
  • Small red or purple spots on the roof of your mouth
  • Swelling in the back of your throat
  • Redness around the back of your throat
  • White patches on the back of your throat
  • Halitosis (bad breath)

The incubation period for strep throat is 2-5 days.

Once you begin to experience any symptoms or notice signs, you should start taking precautions not to infect those around you. You can spread the infection to other people through sneezing and coughing. You can also spread the infection by touching objects if your hands have been in contact with your saliva and mucus. Covering your mouth when coughing or sneezing, avoiding sharing beverages, and regular hand washing can help.

The most common cause of throat pain is typically a virus, not strep throat. Viral infections normally improve on their own. The antibiotics used for treating strep throat are not beneficial if you have a viral infection. Common symptoms of viruses that you should not expect to experience if you have strep throat include a runny nose, hoarse voice, pink or crusty eyes, and diarrhea.

Rare Symptoms

You might experience less common symptoms of strep throat. Their presence does not necessarily mean that your infection is more dangerous or more likely to cause serious complications.

  • Nausea and vomiting
  • Rash on your chest and neck
  • Abdominal pain
  • Muscle aches
  • Stiff joints
  • Painful lymph nodes

Urgent Signs and Symptoms

Strep throat is not usually dangerous, but it can cause medical emergencies, though this is rare.

When to Seek Emergency Care

If you have strep and experience the following symptoms, seek medical care right away.

  • Trouble breathing or shortness of breath
  • Dizziness, feeling faint or passing out
  • Blue or pale lips or fingers
  • Trouble swallowing

Complications

Strep throat can cause a number of serious complications, though they are rare. These are more likely to occur if your infection is not treated or if you have a weak immune system. Sometimes, however, serious complications can occur without an obvious reason. 

The complications of strep throat are typically divided into two main categories: suppurative (pus-forming) and non-suppurative (non-pus-forming). These classifications mean more to doctors than to patients, but the distinction will dictate your treatment.

Pus-Forming Complications 

These may require an intervention such as surgery to drain the pus.

The three most common pus-forming complications that can occur after strep throat are:

  • Peritonsillar abscess: An abscess is a walled-off collection of bacteria that may create a bump, and it can form behind and in front of the tonsil due to strep throat. This may begin two to eight days after a sore throat and may be associated with having an antibiotic-resistant infection. 
  • Otitis media: An infection of the middle ear, can develop, and it is often characterized by pain, fever, and fluid drainage. 
  • Sinusitis (sinus infection): Most of the time, sinusitis is a mild infection caused by a virus, but when it occurs as a complication of strep throat, it is caused by a bacterial infection and requires antibiotic treatment. 

Complications of strep throat can be suppurative (pus-forming) and non-suppurative (non-pus-forming).

Non-Suppurative Complications

These are often treated with oral or intravenous medication that works to treat the whole body.

Common non-suppurative complications that can occur after strep throat include:

  • Arthritis, which is characterized by swollen joints and generalized pain
  • Generalized swelling throughout the body, especially in the abdomen, face, eyes, feet, ankles, or hands
  • Rheumatic fever, which is caused by an autoimmune reaction to the infection. The antibodies that your body forms against the strep bacteria may react against your own tissues. Rheumatic fever can affect your heart, joints, and brain and result in chronic rheumatic heart disease.
  • Scarlet fever is caused by an erythrotoxin produced by the bacteria. Warning signs of scarlet fever include changes in the color or amount of your urine, severe joint pain, high fever, rash, seizures, or other neurological changes. Scarlet fever is usually accompanied by a sandpaper-like rash and sometimes a red bumpy tongue, in addition to other strep throat symptoms.
  • Post-streptococcal glomerulonephritis, a kidney condition that may occur after strep throat that can be very serious, resulting in kidney failure. Symptoms include decreased urine output, rust-colored urine, and bloody urine.
  • Toxic shock syndrome (TSS), though this is uncommon
  • Henoch-Schonlein purpura, an autoimmune syndrome associated with Group A strep. It results in low platelets and bruising, among other serious symptoms involving the kidneys and digestive tract.

Frequently Asked Questions

  • Does strep throat cause diarrhea?

    No. Strep throat can cause abdominal pain and nausea, but if you have diarrhea with strep throat, it’s likely due to another cause, such as a different viral or bacterial infection.

  • Why does strep throat cause bad breath?

    The bacteria that cause strep throat also cause halitosis. The bacteria travel into the mouth via nasal passages or from the back of the throat. Halitosis can also be caused by upper respiratory infections, tonsillitis, or a lung infection.

  • How long will it take for strep throat symptoms to go away?

    Treated with antibiotics, strep throat symptoms begin to go away within the first two doses. After 24 hours, you should no longer be contagious. While it’s possible for strep throat to clear up on its own, it takes significantly longer, and you’ll remain highly contagious for about three weeks. Untreated, you also risk serious complications such as scarlet fever and rheumatic fever.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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