When sore throat season hits, even a mild tickle can send your mind racing. Is it just allergies? Could it be a cold? Or is it strep throat?
According to Dr. Leah Schulz, family medicine physician at The Iowa Clinic in West Des Moines, that kind of uncertainty is completely normal.
“It can be really tough to tell strep throat apart from other common illnesses at first,” says Dr. Schulz. “But there are a few key symptoms that help us narrow it down, and getting tested is the best way to know for sure.”
Here’s what you need to know about the differences – and when to seek care.
What Causes a Sore Throat?
Most sore throats are caused by viruses – the same ones that lead to colds or the flu. These viral infections often come with other symptoms like:
- Coughing
- Sneezing
- Runny nose
- Mild fever
- Fatigue
Bacterial infections, like strep throat, are less common but can be more severe. Unlike a viral illness, strep usually doesn’t come with a cough or congestion – and it may need antibiotics to go away.
Sore Throat vs Strep Throat
When it comes to determining if it’s a sore throat or strep throat, there are a few key indicators:
| Symptom | Viral Sore Throat | Strep Throat |
| Sore throat | Yes | Yes (often severe) |
| Fever | Possible | Often high (101 or higher) |
| Cough | Common | Rare |
| Runny or stuffy nose | Common | Rare |
| Swollen lymph nodes | Sometimes | Yes |
| White patches on tonsils | Rare | Common |
| Headache or stomachache | Sometimes | Common in kids |
“Strep throat tends to come on more suddenly and can make you feel worse overall,” Dr. Schulz explains. “If you have a high fever and no cough, it’s more likely to be strep.”
When Should You See a Doctor?
If your sore throat is mild and you’re otherwise feeling OK, it’s usually fine to rest at home and treat symptoms with fluids, over-the-counter pain relievers, and throat lozenges.
But you should schedule a visit if:
- Your sore throat lasts more than a few days
- You have a high fever
- You have trouble swallowing or opening your mouth
- You notice white patches in your throat
- Your symptoms come on suddenly and are severe
Children are more likely to develop strep than adults. However, if you or a loved one are showing signs of strep throat, it’s a good idea to visit an urgent care or your primary care doctor for a throat culture.
A rapid strep test provides results within minutes, while a throat culture can take 24-48 hours to diagnose or rule out strep throat. Sometimes, even if you produce a negative rapid strep test, your doctor may send the sample out to a lab for a throat culture. A rapid strep test alone is sometimes not enough to determine the presence of the bacteria that causes strep throat.
Relief from Frequent Strep Throat
Patients who suffer from strep throat often, multiple times a year, may be good candidates for a tonsillectomy. The Iowa Clinic’s Ear, Nose, and Throat physicians are available to answer your questions on when it may be time to consider having those tonsils out.
Doctors often recommend that patients who have strep throat 7 or more times each year talk with their primary care provider about surgical options. However, it’s important to note that a tonsillectomy does not remove the risk of strep throat altogether. It can help lessen the severity of the symptoms of strep throat – and it can lessen the occurrence of strep throat. Meaning you won’t need to reach for the aspirin or lozenges as often.
Whether it’s strep throat or something else, The Iowa Clinic is here to help you get answers and relief. With primary care physicians across the Des Moines metro and same-day appointments available, you won’t have to wait long to start feeling better. Schedule an appointment online today or call 515.875.9000.
LeahSchulz , DO
Leah Schulz, DO joined The Iowa Clinic West Des Moines Family Medicine department for its outstanding reputation in delivering high-quality primary and specialty care across the Des Moines area. She was drawn to family medicine for the opportunity to care for patients of all ages while managing a wide range of health conditions. Dr. Schulz finds it especially rewarding to build meaningful relationships with patients, help others, and continue learning something new every day.
Originally from Carroll, Iowa, Dr. Schulz looks forward to caring for the people of central Iowa. Outside of medicine, she is an avid college football fan and especially loves cheering for Notre Dame, where she once worked in the Sports Nutrition department making smoothies for the football team. In her free time, Dr. Schulz enjoys riding her bike, trying new restaurants, cooking, and spending time with her husband. If she weren’t a physician, she would have pursued a career as a podcast host.