While both infections may cause a sore throat, unlike a cold, strep throat does not cause a cough and runny nose. Additionally, strep can cause tiny red spots on the roof of the mouth called petechiae.

The above information comes from the Centers for Disease Control and Prevention (CDC).

The two conditions also have different possible complications. Although it is uncommon, strep may lead to serious complications. In contrast, complications of a cold are generally less severe.

This article discusses cold versus strep throat, including the symptoms, which condition is worse, treatments, and when to call a doctor. It also examines whether strep can look like a cold.

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Both colds and strep throat are microbial infections. However, the microbes that cause a cold are viruses, and those that cause strep throat are bacteria.

More than 200 types of viruses can cause symptoms of the common cold. Often, this is rhinovirus, but can also include coronavirus, enterovirus, and more.

Although the two types of infections have some symptoms in common, they have differences. The chart below outlines the symptoms of each condition:

ColdStrep throat
Symptoms• sore throat
• runny nose
• sneezing
• coughing
• stuffy nose
• watery eyes
• postnasal drip (mucus dripping down throat)
• fever (many people do not get this)
• sore throat that starts rapidly
• fever
• swollen, red tonsils
• pain when swallowing
• white patches or streaks of pus on tonsils
• swollen lymph nodes in front of the neck
• petechiae on the roof of the mouth

Additionally, strep throat may less commonly cause other symptoms, especially in children. These include:

  • headache
  • nausea or vomiting
  • stomach pain
  • rash

Some symptoms may overlap. For instance, both infections can cause a sore throat.

However, strep throat does not cause a cough and runny nose, typical symptoms of cold. Strep throat also produces signs in the throat and mouth that occur with a cold, such as white streaks on the tonsils.

A person can have both infections at the same time. A 2016 research review stated that viral and bacterial infections of the respiratory tract can occur at the same time. This is called a coinfection or secondary bacterial infection.

Anecdotally, healthcare professionals have reported frequently seeing cold and strep coinfection. If a person is concerned about themselves or a child having strep, it is important to get tested.

Yes, people generally consider strep throat to be worse than a cold. It can cause serious effects if the bacteria spread to other body parts. Although complications are uncommon, they may include:

It is important to note that as of December 2022, the World Health Organization (WHO) has reported increased cases of invasive group A strep. This type of infection can cause more serious, potentially life threatening side effects.

If a person with strep throat receives prompt treatment, their outlook is generally positive. Many people recover within a few days.

Conversely, while someone may feel very ill during a cold, their immune system can usually clear the infection and prevent it from causing harm. That said, it is possible to get complications from a cold because the virus can lead to other infections, such as:

  • sinus infection
  • ear infection
  • acute bronchitis, which is inflammation of the breathing tubes that comes on suddenly and lasts a short time

Additionally, some people have a prolonged cough after a cold that can last weeks to months. The worst symptoms typically subside within 1 week, but a longer duration may be necessary before the symptoms disappear completely.

The treatment differs since the causes of a cold and strep throat differ. Details are below:

Treatment for colds

As viruses cause colds, doctors do not prescribe antibiotics for them. Instead, they recommend home care measures and over-the-counter (OTC) medications to relieve symptoms.

Home care measures may include practices like:

  • getting plenty of rest
  • drinking plenty of fluids
  • taking cough drops

OTC medications may include pain relievers, such as acetaminophen (Tylenol) and ibuprofen (Advil).

Additionally, adults can take cough and cold medications. For children ages 4 years and older, a parent must ask a doctor which products are safe for them. Children younger than 4 years old must not take cough and cold medications unless a doctor recommends them.

Treatment for strep throat

People with strep throat who have no symptoms may be carriers of bacteria and usually do not need treatment.

In contrast, if someone has symptoms, doctors prescribe antibiotics. These medications can:

  • decrease symptoms
  • reduce the length of time a person has the infection
  • prevent serious complications or the transmission of strep to others

When a person has a cold, it is advisable for them to call a doctor if they have any severe or concerning symptoms, including:

  • fever that lingers longer than 4 days
  • difficulty with or fast breathing
  • dehydration

If a person has a sore throat or other symptoms of strep throat, it is a good idea for them to contact a doctor. They can perform a rapid test to determine if it is strep.

When strep throat is present, it is important to start treatment right away to reduce the risk of complications. If someone with strep does not feel better after taking antibiotics for 48 hours, contacting a doctor is important.

An examination of cold versus strep throat reveals that while some symptoms may overlap, there are differences. For example, unlike a cold, strep throat does not cause a cough or runny nose. Strep throat also causes signs in the mouth and throat that do not occur with a cold, such as white streaks on the tonsils.

People usually recover from colds without complications. Although complications are not common with strep throat, they do occur and can sometimes be severe.

Treatment of a cold involves home care and — except for young children — OTC medications, but treatment of strep throat includes antibiotics.