A runny nose is typically not a symptom of Strep throat, a bacterial infection caused by Group A Streptococcus (GAS). The absence of upper respiratory symptoms, such as a runny nose, sneezing, or congestion, distinguishes a Strep infection from a common cold. This distinction is important because bacterial infections require antibiotic treatment, while a common cold is caused by a virus.
Strep Throat The Typical Symptom Profile
Strep throat is caused by Streptococcus pyogenes, which primarily infects the throat and tonsils. Symptoms often appear suddenly and are more severe than a typical sore throat. The classic presentation includes a painful, rapid-onset sore throat and pain when swallowing.
A common sign is a fever, which may reach 101°F or higher. The tonsils often become visibly red and swollen, sometimes displaying white patches or streaks of pus, known as exudates. The lymph nodes in the front of the neck are frequently swollen and tender to the touch.
Some patients, particularly children, may also experience tiny red spots on the roof of the mouth, called petechiae, along with headache, nausea, or abdominal pain. Symptoms rarely present in an uncomplicated Strep infection are those associated with a cold, such as a cough, hoarseness, or nasal discharge.
Viral vs Bacterial Sore Throats Differentiating Symptoms
The presence of cold-like symptoms is the most helpful indicator that a sore throat is caused by a virus rather than Strep bacteria. A runny nose, coughing, hoarseness, or general congestion are strong signals that the illness is a common cold or other viral infection. Viral infections are responsible for the majority of sore throats and do not respond to antibiotics.
Medical professionals use specific criteria to estimate the likelihood of Strep throat. This scoring system often incorporates the absence of a cough as a factor to determine whether testing is necessary. The presence of a runny nose or cough significantly shifts the probability away from a Strep diagnosis.
A viral sore throat usually develops gradually, and the symptoms, including a cough and red or watery eyes, typically resolve on their own. In contrast, Strep throat tends to have a sudden onset and is rarely accompanied by upper respiratory symptoms.
When and How to Get Tested
Self-diagnosis is inadequate when Strep is suspected, as symptoms can overlap with other conditions, including viral infections like mononucleosis. Seeking medical attention is necessary to confirm the presence of Group A Streptococcus bacteria. Accurate identification is important because untreated Strep throat can lead to serious complications.
The diagnostic process typically begins with a throat swab to collect a sample from the back of the throat and tonsils. The first test performed is often the Rapid Strep Test (RST), which provides results in minutes. While the RST is highly accurate if positive, it may miss some infections, resulting in a false negative.
If the RST is negative, but Strep is still strongly suspected, a healthcare provider may send the swab for a throat culture. A throat culture is more sensitive than the rapid test, but it requires 24 to 48 hours for the bacteria to grow and provide a definitive result.
Treatment and Managing Contagion
Once a Strep diagnosis is confirmed, treatment involves a course of antibiotics, such as penicillin or amoxicillin, to eliminate the bacteria. Beginning treatment promptly reduces the duration of symptoms and lowers the risk of complications. The full course of antibiotics, typically lasting 10 days, must be completed even if the patient feels better sooner.
Stopping antibiotics early allows some bacteria to survive, which can lead to a recurrence of the infection. This can result in serious complications like rheumatic fever, a condition that affects the heart, joints, and brain. A person is generally no longer considered contagious after they have been on antibiotics for at least 24 hours.
To prevent the spread of the bacteria, basic hygiene measures are important, including frequent handwashing and covering coughs and sneezes. Individuals should stay home from work or school until they have been on antibiotics for a full day and their fever has resolved.