Published: September 18, 2025
Estimated reading time: 6 minutes
A scratchy throat doesn’t always mean strep. There are many reasons kids experience throat discomfort, including the flu, COVID-19, seasonal allergies or the common cold.
“Assuming you know what the cause of the sore throat is can delay treatment and cause unnecessary worry,” said Patrick K. Hynes, M.D., pediatrician with Norton Children’s Medical Group. “There are several strep throat myths, but as the sooner you know what you’re dealing with, the sooner your child can start feeling better.”
The hallmark strep throat symptom is a sore throat that happens suddenly. Other symptoms may include:
While these may be common, these strep throat symptoms vary from person to person. Some people with strep throat may not develop any symptoms, or may have very mild symptoms.
Myth: You can tell it’s strep just by looking in the throat.
Truth: Only a strep test can confirm a case of strep.
Visual clues such as white patches on the tonsils or swelling in that area do not necessarily mean someone has strep throat.
“There are several viral illnesses that have overlapping symptoms with strep,” Dr. Hynes said. “Not all strep infections have the same symptoms, so it’s best to get that test to confirm what sort of illness someone might have.”
There are two common strep tests:
Rapid strep test:
Throat culture:
Strep is an infection that requires antibiotic treatment. Strep throat does not go away on its own and may lead to serious complications. Antibiotics can shorten the duration and severity of strep throat and reduce the chances of spreading strep to others.
“Strep is a bacterial infection. We don’t want to give someone antibiotics unless we know for sure the illness isn’t viral,” Dr. Hynes said. “Unnecessary antibiotic use can contribute to antibiotic-resistant versions of certain illnesses.”
Myth: Strep throat always has the same symptoms.
Truth: Strep symptoms vary more than you think.
Strep throat symptoms affect people differently. Some people have very mild symptoms, and others may experience more severe strep throat symptoms.
Strep is less common in infants and toddlers. Symptoms can be very mild and may include:
Strep throat is more common in children between ages 5 and 15. Symptoms have a sudden onset and may include:
Adults report all these symptoms and have the same variety in severity as other age groups.
Myth: Strep throat will go away on its own.
Truth: Sometimes, but antibiotics are essential for proper treatment
While the body may get over strep without antibiotics, untreated strep throat can lead to serious complications, including:
Spread of infection in the body, including to the:
Strep infection may lead to inflammatory illnesses, including:
Antibiotic treatment may shorten the duration of strep throat symptoms, shorten how long you are contagious and prevent spreading the infection.
“Be sure to take the entire course of medication prescribed to you or your child,” Dr. Hynes said. “Even if you start feeling better, take all the medicine you have to eliminate all the streptococcus bacterium and prevent reinfection.”
Myth: If your child has strep, their tonsils need to come out. Also, kids cannot get strep without tonsils.
Truth: Tonsil removal is only recommended in specific situations and even after tonsil removal, children can still get strep. Tonsillectomy is only recommended after repeated infections.
Tonsillitis is an infection in one or both tonsils, the small lumps of tissue in the back of the throat that help protect the body from infections. Strep is causes by a specific bacterium, while tonsilitis can be caused by viruses, bacteria or other illnesses. You still can get strep throat if have had a tonsillectomy. There are specific guidelines for tonsillectomy (surgical removal of tonsils).
A health care provider might recommend removing the tonsils if a child has a certain number of infections: seven infections a year, more than five infections a year for two years, or three infections for three years.
How long Is a child contagious with strep?
About 24 to 48 hours after starting antibiotics, contagiousness significantly decreases.
“It is important to keep kids home, away from other people, and doing supportive care,” Dr. Hynes said.
When should I seek care for strep throat?
Contact your pediatrician urgently for:
Strep throat is a bacterial illness that affects the throat and tonsils. Strep throat symptoms can mimic other illnesses, so an accurate diagnosis is necessary for prompt and effective treatment of strep.
“The sooner you see your pediatrician, the sooner we can get your child feeling back to normal,” Dr. Hynes said.
Call 911 or go to an emergency department immediately if your child experiences: