Symptoms of Strep Throat

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Strep throat has a number of classic signs and symptoms that many people immediately associate with the bacterial infection, such as throat pain and swelling, enlarged tonsils, and bad breath. Fever, chills, headaches, and decreased appetite can also occur. All of these, however, are also typical of most viral infections.

Because of this, signs and symptoms alone cannot be used to diagnose strep throat, though a doctor will certainly look for them to help determine if strep testing is necessary.

strep throat symptoms
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Frequent Symptoms

The time between exposure to the bacteria and the development of strep throat symptoms is called the incubation period. Strep throat typically has an incubation period of 2-5 days. You are considered contagious in 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

The incubation period for strep throat is 2-5 days. Once you develop symptoms you are contagious and can spread strep to others.

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, coughing, and 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.

Know, though, that a sore throat is typically due to a virus, not strep throat. Viral infections normally improve on their own and do not respond to the antibiotics used for strep throat. 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 several other symptoms if you have strep throat, but these are less common. Their presence does not necessarily mean that your infection is more dangerous or more likely to cause serious complications of strep throat.

  • 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


Strep throat can cause a number of serious complications, though they are rare. Such concerns are likely to occur if the 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 patients, but which camp the issue you are experiencing falls into will dictate what treatment is considered.

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 abscessan abscess (a walled-off collection of bacteria that may create a bump) that forms behind and in front of the tonsil. This may begin two to eight days after a sore throat and is associated with having an antibiotic-resistant infection. 
  • Otitis media—an infection of the middle ear, 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 or drainage if there is an abscess. 

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

Non-Suppurative Complications

These are often treated with 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 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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