Strep throat is usually accompanied by a fever and white patches on your tonsils. But the only way to be sure it’s strep throat is to have a strep test done.

To go or not to go to the doctor? That’s often the question when you have a sore, scratchy throat. If your sore throat is due to strep throat, a doctor can prescribe you antibiotics. But if it’s due to a virus, like a cold, then treatments are of the at-home variety.

If you think you should go to the doctor, definitely go. However, this guide may help you decide if your symptoms are likely to improve on their own with at-home or over-the-counter therapies.

The following are differences in physical signs and symptoms that you may experience when you have a sore throat. However, it isn’t always clear by looking at the throat what type of infection a person has.

As you’ll see, several of the different sore throat causes have similar symptoms.

ConditionSymptomsThroat appearance
Healthy throatA healthy throat should not cause pain or difficulty swallowing.A healthy throat is usually consistently pink and shiny. Some people may have noticeable pink tissue on either side of the back of their throat, which is usually the tonsils.
Sore throat (viral pharyngitis)Cough, runny nose, or hoarseness that changes the sound of a person’s voice. Some people may also have conjunctivitis or pink eye symptoms. Most people’s symptoms subside within a week or two, but are usually mild and not accompanied by a high fever.Redness or mild swelling.
Strep throatFast onset with pain when swallowing, fever greater than 101°F (38°C), swollen tonsils, and swollen lymph nodes.Swollen, very red tonsils and/or white, patchy areas on the tonsils or in the back of the throat. Sometimes, the throat may be red with moderate swelling.
MononucleosisFatigue, fever, sore throat, body aches, rash, and swollen lymph nodes in the back of the neck and armpits.Redness in the throat, swollen tonsils.
Tonsillitis (not caused by strep bacteria)Pain when swallowing, swollen lymph nodes in the neck, fever, or changes in the voice, such as sounding “throaty.”Tonsils that are red and swollen. You may also notice a coating over the tonsils that is either yellow or white.

The following are some of the most common sore throat causes:

  • Strep throat: The bacteria group A Streptococcus is the most common cause of strep throat.
  • Sore throat (viral pharyngitis): Viruses are the most common cause of sore throat, including rhinoviruses or a respiratory syncytial virus. These viruses can cause other symptoms, such as:
    • a cold
    • earache
    • bronchitis
    • sinus infection
  • Mononucleosis: The Epstein-Barr virus is the most common cause of mononucleosis. However, other viruses can also cause mononucleosis, such as cytomegalovirus, rubella, and adenovirus.
  • Tonsillitis: Tonsillitis is when the tonsils are predominantly inflamed and infected, as opposed to other structures in the throat. It’s usually caused by viruses, but it can also be caused by bacteria — most commonly, A Streptococcus. It may also be caused by an underlying infection, such as an ear or sinus infection.

When you have a virus, identifying the specific virus is usually less important than the symptoms it causes. However, your doctor may perform a test to identify the presence of strep bacteria and determine potential treatments.

In many cases, your age may clue in your doctor to the likely cause. According to the Centers for Disease Control and Prevention (CDC), strep throat is most common in those ages 5 to 15. Adults and those younger than age 3 rarely get strep throat. An exception is when an adult comes in contact with children or is the parent of a school-age child.

Your doctor can also perform a visual examination of your throat, taking into consideration your signs and symptoms. If a strep throat is suspected, they can perform a quick test that involves swabbing the throat to test for the presence of group A strep bacteria. This test is called a rapid strep test.

If mononucleosis is suspected, most clinics have a quick test that can detect if you have an active infection with just a small drop of blood from a finger stick. Results are often available within 15 minutes or less.

Bacteria is the underlying cause of strep throat, so doctors prescribe antibiotics to treat it. Most patients report improved symptoms within 24 to 48 hours of taking antibiotics for strep throat.

While it’s nice that antibiotics can quickly improve symptoms, these medications are primarily given for strep throat because the condition can cause serious and chronic infections in other places, such as your heart, joints, and kidneys.

The medication of choice for strep throat is usually from the penicillin family — amoxicillin is a common one. However, other antibiotics are available if you’re allergic to these.

Unfortunately, antibiotics won’t work against viruses, including those that cause tonsillitis, mononucleosis, or sore throat.

To reduce throat pain, you can also try the following lifestyle remedies:

  • Rest as much as possible.
  • Drink plenty of water to reduce sore throat and prevent dehydration. Consuming warm teas or hot soups may also help.
  • Gargle with a saltwater solution — 1/2 teaspoon of salt and 1 cup of water — to increase comfort.
  • Use throat lozenges as directed.
  • Take over-the-counter pain relievers, such as ibuprofen or acetaminophen.

Some people may also use a cool-mist humidifier to relieve their throat discomfort. If you do use this, be sure to clean the humidifier as recommended to ensure the water doesn’t attract mold or bacteria.

See your doctor if you experience the following symptoms related to your sore throat:

  • fever that’s higher than 101.5°F (37°C) for 2 days or more
  • throat swelling that makes it difficult to swallow
  • back of the throat has white patches or streaks of pus
  • having difficulty breathing or swallowing

If your sore throat symptoms worsen, see your doctor or healthcare provider as soon as possible.

The throat is a vulnerable place to experiencing swelling and irritation due to colds, strep throat, ear infections, and more. The sudden onset of fever and other symptoms is one way to tell the difference between strep throat — which usually causes fever — and a sore throat due to a virus.

If you’re not sure or are in a lot of pain, talk with your doctor or another healthcare provider.