How to Tell If You Have Strep Throat

Sore throats are among the most common of the minor illnesses that plague parents and children. Often sore throat is one of the earliest signs of an upper respiratory illness, and it is even more often one of the several symptoms. So how do you as a parent tell whether your child may benefit from seeing a physician to see if you or your child has strep throat, or whether the sore throat is just a symptom of a viral illness? This is really pretty straight forward, and you just need to know the basics in order to be right most of the time. Keep in mind that when I say “be right” I mean knowing whether to have your child seen, not to tell with certainty whether your child has streptococcal pharyngitis.

Keep in mind the following facts:

  • Strep throat is much more common in children than it is in adults. Up to 30% of cases of sore throat seen in physician’s offices are strep throat in the 5-15 year old age range, as opposed to less than 10% of adults.
  • In streptococcal phayrngitis a sore throat, usually severe, is the primary symptom. Other symptoms like runny nose and cough are usually absent. If a runny nose and head congestion are present, strep throat is unlikely.
  • Streptococcal pharyngitis comes on quite suddenly. A sore throat that comes on gradually over several days is not often strep.
  • Usually fever is present, and usually a fairly high fever of greater than 102 degrees Fahrenheit.
  • Swollen lymph nodes that are tender in the anterior neck are commonly associated with this condition.
  • On looking at the throat if you see small bright red patches called petechiae on the soft palate, and a patchy whitish yellow exudate on the throat strep throat is more likely.

In summary you should have your child seen in the first day or two of a severe sore throat that is the primary symptom, without runny nose or congestion, that is associated with fever. Having swollen anterior neck lymph nodes and a petechial rash on the throat associated with a patchy white or yellow exudate on the tonsils. It is important to have your child seen early in the course of strep throat because although early treatment in the first two days of symptoms may shorten the illness by a day or two, treatment after 2-3 days of symptoms has not been shown to reduce the duration of the illness.