The difference between tonsilitis, strep throat and sore throat

A sore throat can be a real pain, quite literally. But not all sore throats are the same. Understanding the differences between a simple sore throat, tonsillitis and strep throat can help you find the right treatment and get back to feeling better faster. This article breaks down the symptoms, causes and treatments for each condition.

What is a sore throat?

A sore throat is a common condition characterized by pain, scratchiness or irritation of the throat. It often makes swallowing uncomfortable. Most sore throats are caused by viral infections like the common cold or flu, but they can also result from environmental factors such as dry air or allergies.

Common sore throat symptoms 

• Pain or scratchiness in the throat
• Difficulty swallowing
• Swollen glands in the neck
• Hoarseness or loss of voice
• Redness in the throat

What is tonsillitis?

Tonsillitis is an inflammation of the tonsils, the two oval-shaped pads of tissue at the back of the throat. Tonsillitis can be caused by both viral and bacterial infections.

Tonsillitis symptoms

• Severe sore throat
• Red, swollen tonsils
• White or yellow coating on the tonsils
• Difficulty swallowing
• Fever and chills
• Swollen lymph nodes in the neck
• Bad breath

Causes of tonsillitis

• Viral infections, such as the common cold and flu 
• Bacterial infections, such as strep throat

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Treatment for tonsillitis

Treatment for tonsillitis depends on the cause. Viral tonsillitis usually resolves on its own with rest, fluids and over-the-counter pain relievers. Bacterial tonsillitis, on the other hand, may require antibiotics. In severe or recurrent cases, a doctor might recommend a tonsillectomy, which is a surgical procedure to remove the tonsils. To learn more about chronic tonsillitis, tonsillectomy surgery and Gundersen’s Ear, Nose and Throat (Otolaryngology) providers, visit our website for more information.  

What is strep throat?

Strep throat is a specific type of bacterial infection caused by group A Streptococcus bacteria. It is most common in children but can affect people of all ages. Unlike a typical sore throat, strep throat requires medical treatment.

Strep throat symptoms

• Sudden, severe sore throat
• Red and swollen tonsils, sometimes with white patches or streaks of pus
• Tiny red spots on the roof of the mouth
• Pain when swallowing
• Fever
• Swollen, tender lymph nodes in the neck
• Headache
• Rash

Causes of strep throat

Strep throat is caused by infection with group A Streptococcus bacteria. It is highly contagious and can spread through airborne droplets when someone with the infection coughs or sneezes.

Treatment for strep throat

Since strep throat is a bacterial infection, it requires antibiotics for treatment. Penicillin or amoxicillin are commonly prescribed. It's important to complete the entire course of antibiotics to fully treat the infection and prevent further complications. Over-the-counter pain relievers can also help alleviate symptoms.

How to differentiate between sore throat, tonsillitis and strep throat

Recognizing the differences between these conditions can help you seek the appropriate treatment.

Sore throat vs. tonsillitis

• Sore throat - Often viral, may have mild to moderate pain, scratchiness and difficulty swallowing. Usually accompanied by cold symptoms like runny nose or cough.
• Tonsillitis 

Can be viral or bacterial, involves severe sore throat, swollen and possibly coated tonsils, fever and swollen lymph nodes.

Tonsillitis vs. strep throat

• Tonsillitis - Can be caused by a variety of viral or bacterial infections.
• Strep throat - Specifically caused by group A Streptococcus bacteria with symptoms like a sudden, severe sore throat, red and swollen tonsils with white patches and fever.

Sore throat vs. strep throat

• Sore throat - Often viral, accompanied by cold symptoms and mild to moderate pain.
• Strep throat - Often bacterial with sudden and severe pain, red and swollen tonsils with white patches, fever and typically requires antibiotics.

When to see a doctor

Most sore throats can be managed at home with rest, fluids and over-the-counter medications. However, you should see your primary care provider or call Gundersen’s free 24-hour nurse advisor line at 608-775-4454 if you experience any of the following symptoms:

• Severe or persistent sore throat
• Difficulty breathing or swallowing
• Fever higher than 101°F 
• Swelling in the neck or face
• A rash
• Blood in saliva or phlegm
• Symptoms that do not improve after a few days

Preventing throat infections

While it's not always possible to prevent throat infections, you can reduce your risk by:

• Washing your hands regularly
• Avoiding close contact with people who are sick
• Not sharing eating utensils, cups or personal items
• Keeping your immune system strong with a healthy diet, regular exercise and adequate sleep

“Sore throats are a common nuisance during cold and flu season. Fortunately, you can reduce your risk with simple practices like washing your hands and avoiding sharing utensils with others."

—Megan Meller, MS, MPH, CIC, CSM, infection preventionist, Gundersen Health System

Understanding the differences between a sore throat, tonsillitis and strep throat can help you determine the best course of action for treatment. While most sore throats are mild and can be treated at home, tonsillitis and strep throat may require medical intervention.

If you're ever in doubt, it's best to consult with your primary care provider to get an accurate diagnosis and appropriate treatment. By staying informed and taking preventive measures, you can reduce your risk of throat infections and maintain better overall health.