Sore Throat vs. Strep Throat: What's the Difference?

Kids pick up germs from everywhere. And sometimes, when they come down with a fever, stuffy nose or a stomachache, it’s hard to know exactly what’s going on.

This can especially be the case for sore throats – and the dreaded strep throat. They’re so difficult to decode that even doctors have to run special tests to get to the bottom of it.

A sore throat “can be caused by hundreds of different viruses” – even allergies, stuffy noses – or simply sleeping with your mouth open, says Dr. Katherine Hebert, pediatric emergency department physician at Children’s Hospital of Michigan in Detroit.

So how is a parent supposed to know? There are a few things to look for.

Usually with strep, which is a bacterial infection, children will also have a fever, Dr. Hebert says. Strep tends to be a more severe sore throat that can make it difficult to swallow, eat and drink. Foul breath and swollen lymph nodes on either side of the front of the neck may accompany a strep infection.

Kids with strep can sometimes experience headache or belly pain and a “sand-papery” rash all over the body, although not always.

Parents can try peering into the back of their child’s throat. With strep, Dr. Hebert says it will look “beefy red,” and, “you do usually see a little bit of white spots with strep – but that actually can happen with viruses too,” like mono.

To know for sure if a child has strep, doctors have to swab the back of the throat and run a test, since many symptoms can be caused by a number of viruses, too. Test results may be rapid (within a couple minutes), but swabs still need to be sent out to the lab, since there is a chance of a false negative within that first day.

For strep throat, doctors will prescribe antibiotics. With sore throat or strep throat, kids will typically start to feel better within three to four days. “The good news is most sore throats get better on their own,” Dr. Hebert says. Even with strep, once a child begins the antibiotics, they’ll start to feel better within a few days. Symptoms will begin to dissipate within 24 to 48 hours (though the sore throat won’t go away that quickly).

Strep should be treated, since there can be some complications if the bacteria spreads through the blood. Antibiotics can help stop some of the complications, Dr. Hebert says.

With strep or regular sore throat, parents can comfort their kids with over-the-counter pain and fever reducers. Dr. Hebert emphasizes the importance of hydration during recovery, no matter how much children protest due to their pain. She suggests sipping on Pedialyte, water, popsicles and tea with honey or lemon. “Getting dehydrated will make you feel so much worse,” Dr. Hebert warns.

Prevent the spread of strep or other viruses in the home by teaching good hand washing. Kids with strep and other viruses are contagious when they have a fever, so avoid close contact with others and sharing foods or drinks.

Children with strep should be seen in the emergency room for dehydration, the inability to take in fluids, extreme fatigue, weakness or neck stiffness.

Even if a parent isn’t sure what’s going on with their child, Dr. Hebert says to seek medical attention.

“If the parents are worried, I always say they should come,” Dr. Hebert says of seeing a physician. “(It’s) never a bad idea to have a second opinion.”


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