Dr. Sapna Verma
Consultant Paediatrician
Most sore throats clear up on their own — but strep requires treatment. Learn the signs and when to get tested.
Every winter, parents ask the same question: is this a normal sore throat or is it strep? It matters, because viral sore throats resolve on their own, while strep throat — caused by Group A Streptococcus — requires a course of antibiotics to prevent rare but serious complications like rheumatic fever.
Clues that point toward strep: sudden-onset severe pain, fever above 38.5°C, swollen tender lymph nodes in the neck, white or yellow patches on tonsils, and a sandpaper-like rash (scarlet fever). Notably absent: runny nose, hoarse voice, and cough. Those symptoms suggest a virus.
Clues that point toward a virus: gradual onset, accompanying cold symptoms (runny nose, hoarse voice, cough), mild redness without pus. Most sore throats in children are viral.
The only reliable way to distinguish them is a rapid strep test — a swab of the throat that gives results within minutes. At Circle Care Clinic we run this in-house. A positive result means a 10-day course of penicillin or amoxicillin. A negative result means we avoid unnecessary antibiotics.
One practical note: if your child's sore throat is so painful they're refusing to drink fluids, or if breathing or swallowing becomes difficult, come in urgently. Peritonsillar abscess — a collection of pus beside the tonsil — is a less common but important complication that requires prompt drainage.
