Strep throat is a bacterial infection that usually causes a sore throat. People often also associate the infection with a fever, but it is possible for a person to have strep throat and not have a fever.

Group A Streptococci bacteria cause strep throat. It is common and can spread easily from person to person.

Some people who have strep throat do not experience any symptoms, while others may have less common symptoms of the disease.

Keep reading for more information on strep throat, including its symptoms, how it spreads, and the treatment options.

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Fever is not always a symptom of strep throat.

People often associate strep throat with a sore throat and fever, but it is possible for a person to have strep throat and not have a fever.

A fever is one of several symptoms that a doctor looks for when diagnosing strep throat. A lack of fever does not necessarily mean that a person does not have the infection, though.

According to the Centers for Disease Control and Prevention (CDC), the most common symptoms of strep throat include:

According to the University of Utah, doctors look for four symptoms that indicate strep throat. The more of these symptoms a person has, the more likely they are to have strep throat:

  • sore throat without cough
  • swollen lymph nodes at the front of the neck
  • fever
  • presence of white pus on the tonsils

To get a diagnosis of strep throat, a person will usually see their primary care provider. During the visit, the doctor will ask them about any symptoms. They will likely examine the person’s throat, take their temperature, and feel over the lymph nodes on the front of the neck.

If strep throat seems likely, a doctor will need to perform a simple strep test to confirm the presence of group A Streptococcus.

To perform a strep test, a healthcare professional will ask the person to open their mouth wide. They will then insert a cotton swab on a stick and swab the back of the person’s throat.

A rapid test on the swab sample will provide positive or negative results, confirming whether the person has strep throat.

In some cases, if a test comes back negative, a doctor may have a laboratory run a throat culture. A throat culture takes longer to produce results, but it can sometimes find infections that the quick test misses.

A doctor is more likely to order a throat culture following a negative test on children because children are more susceptible to rheumatic fever from an untreated strep infection than adults.

Strep throat spreads through contact with affected saliva and nasal secretions. A person can still spread strep even if they are asymptomatic.

A person can catch strep throat from:

  • sharing food or drink with someone who has the infection
  • touching an object that a person with strep throat coughed or sneezed on, then touching their own mouth or nose
  • touching skin sores that group A Streptococcus caused, for example, impetigo
  • breathing in respiratory droplets from a person with the infection

A person should take all prescribed antibiotic treatment and be aware that strep infection can still spread when they first start treatment.

A person should take reasonable precautions, such as washing their hands frequently and coughing or sneezing into their elbow rather than their hand, to help prevent spreading strep throat to others while they are taking antibiotics.

If a person tests positive for strep throat, the primary treatment is a round of antibiotic treatment. Either penicillin or amoxicillin is generally the first-line treatment for group A Streptococcus infection. A doctor can prescribe other antibiotics that are effective against strep if a person is allergic to penicillins.

A doctor may also recommend medications to treat the pain. In some cases, these may be over-the-counter medications that are available at most pharmacies.

If a person shows no symptoms or signs of infection but tests position for group A Streptococcus, they are a carrier. A carrier is less likely to spread bacteria to others and very unlikely to develop complications from untreated strep. They usually do not need antibiotics.

A carrier likely will not know that they have strep. If they get a sore throat due to a viral infection, the rapid strep test may come back positive. In these cases, it may be hard to identify what is causing the sore throat.

If a person keeps getting a sore throat after taking the right antibiotics, it is likely that they are a carrier and that a viral throat infection is causing the symptoms instead.

If a person suspects that they or their child may be a carrier, they should talk to their doctor.

According to the CDC, viruses (such as those that cause colds and flu) are the most common cause of sore throats in people. Other potential causes of a sore throat may include:

  • smoking
  • exposure to secondhand smoke
  • allergies
  • talking or singing for extended periods

Strep throat is a common bacterial infection that causes an often severe sore throat without a cough.

A person may also have other symptoms, such as a fever, but this is not always the case. A person can still have strep throat without a fever.

A rapid strep test or throat culture can confirm whether a person has strep throat. If strep throat is present, a doctor will prescribe an appropriate antibiotic to treat the infection.