What is the difference between strep throat and tonsillitis

The terms strep throat, sore throat, and tonsillitis often are used interchangeably, but they don’t mean the same thing. Many people don’t realize that there is a difference and often treat their symptoms without knowing what is wrong.

Sore Throat 

A sore throat is a general term that can describe any type of pain, irritation, or scratchiness in the throat. A sore throat can be caused by many things, including:

  • Allergies (postnasal drip)
  • Viruses (including the flu)
  • Bacteria (such as strep throat)
  • Smoking
  • Dry air

If you have a sore throat, try sucking on ice chips, popsicles or lozenges, gargling salt water, or drinking warm beverages with honey. If the sore throat is the result of a virus, antibiotics will not work as treatment. 

Tonsilitis

Tonsillitis is an infection of the tonsils, two lymph nodes located on each side of the back of the throat. Tonsillitis can be caused by a bacterial or viral infection. As mentioned previously, a sore throat is a symptom of tonsilitis and is usually accompanied by discoloration and swelling in or around the tonsils, as well as a fever. This infection is most common in children between the ages of five and 15, but it can occur at any age. It is more common in the winter and spring.

Tonsillitis usually goes away on its own within a week, however, if sore throat remedies do not help relieve the symptoms and/or they reappear frequently, your provider may recommend having your tonsils removed. If tonsillitis is the result of a bacterial infection, an antibiotic may be prescibed. 

Strep Throat

Strep throat is caused by a bacterial infection known as Streptococcus pyogenes, also called group A Streptococcus. Streptococcal bacteria are contagious. They can spread through droplets when someone with the infection coughs or sneezes, or through shared food or drinks. You can also pick up the bacteria from a doorknob or other surface and transfer them to your nose, mouth, or eyes.

Symptoms include a sore throat, a fever (higher than with tonsilitis), swollen lymph nodes in the neck and throat, redness or white spots in the throat, fatigue, and body aches. Because strep throat is caused by a bacteria, it should be treated with antibiotics once diagnosed. 

If you suspect you or your child has strep throat, contact your primary care provider. Only a strep test can confirm strep throat diagnosis, and a diagnosis is required to recieve proper antibiotics. 

While strep throat, a common sore throat, and tonsillitis have similar symptoms, they are different conditions. If you are unsure of whether or not you or a loved one have a simple sore throat or something more, we encourage you to visit your primary care provider. 

Sore throats are very common, but that doesn’t make them less uncomfortable: A sore throat can make it painful to speak or swallow.

And if you’ve got a sore throat, you want it gone—but what’s causing your discomfort? 

Tonsillitis and strep throat are two extremely common infections that may cause a sore throat, especially in children. The two infections can be linked, but they are not the same thing. 

In this article, I’ll discuss the difference between tonsillitis and strep throat, symptoms of each infection, and risk factors for both.

Finally, I’ll talk about treatment and prevention, and discuss when it is time to see a doctor. 

Tonsillitis and Strep Throat: What’s the Difference?

Both tonsillitis and strep throat affect the throat and the tonsils, the two, small round lumps of tissue in the back of your throat. Both infections are extremely common.

Tonsillitis may be caused by bacterial infections, including group A streptococcus (the bacteria that causes strep throat), but is more commonly caused by a viral infection. 

To diagnose tonsillitis, the majority of patients will be physically examined by their doctor. Since strep throat can cause tonsillitis, your doctor will often do a strep test.

If the test is negative, the tonsillitis is likely caused by a virus. In this case, antibiotics are neither necessary nor useful.

The tonsillitis—and symptoms—must run their course, with the help of over-the-counter medications for symptomatic relief, as well as rest and hydration. 

Strep throat is a bacterial infection of the throat and tonsils that is highly contagious. To diagnose strep throat, a rapid strep test can bet.

Results often appear within minutes. If you test positive for strep throat, your doctor will likely prescribe antibiotics.

Symptom relief should appear within 24-48 hours, and the infected individual is no longer considered contagious after 24 hours of antibiotics. 

Unsure if you have tonsillitis or strep throat? Chat with a doctor using K Health.

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Symptoms

Tonsillitis and strep throat may have similar symptoms, though there are a few notable differences.

Symptoms of tonsillitis

Common symptoms of tonsillitis include:

  • Sore throat, sometimes severe
  • Red and swollen tonsils
  • Discomfort or trouble swallowing
  • White or yellow coating on the tonsils
  • Swollen glands in the neck
  • Fever
  • Bad breath

In some cases, individuals may experience stomach pain, ear pain, and a headache.

In babies or children too young to tell you their symptoms, refusal to eat, fussiness, or drooling due to pain swallowing may be signs of inflamed tonsils, but need urgent, in-person medical care. 

Symptoms of strep throat

Strep throat may look like other forms of sore throats and tonsillitis, but some common symptoms of strep include:

  • Sore throat that comes on quickly
  • Pain with swallowing
  • Fever
  • Swollen or inflammation of the tonsils, with white spots or streaks on them
  • Tiny, red spots on the roof of the mouth
  • Swollen or tender lymph nodes in the neck

Like tonsillitis, some may experience nausea, body aches, and headaches when infected with strep throat. Strep throat typically does not present with runny nose or sniffles.  

Risk Factors

Both tonsillitis and strep throat are common and can infect anyone, but both are more common in children.

Strep throat is most common in the late fall and early spring, but can occur at any time of year.

Strep throat is also highly contagious, so children in school settings are more prone to infections given their close proximity to others. 

Treatments and Prevention

Bacterial infections, including strep throat, are usually treated with antibiotics.

For viral cases of tonsillitis, treatment is with over-the-counter pain relievers like acetaminophen (Tylenol) and NSAIDs (ibuprofen, Advil, Motrin).

Some common home remedies include gargling salt water for sore throat, getting lots of sleep, drinking warm fluids, eating soft foods if your throat is sore, and lozenges. 

To prevent both strep throat and tonsillitis, the best thing you can do is practice good hygiene.

This includes washing your hands frequently, coughing and sneezing into your elbow, and not sharing utensils, food, or drinks. 

Unsure if you have tonsillitis or strep throat? Chat with a doctor using K Health.

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When to See a Doctor

If you suspect you or your child may have strep throat or tonsillitis, or they have had close contact with someone diagnosed with strep throat, make an appointment with your doctor.

If left untreated, strep throat can develop into more serious conditions.

If you or your child’s symptoms do not improve, or they worsen, reach out to a doctor for further guidance.

Frequently Asked Questions

What's worse, tonsillitis or strep throat?

Generally speaking, strep throat symptoms tend to be more severe and if left untreated, the possible spread of infection may pose more of a risk to your general health. Both tonsillitis and strep throat present with symptoms that may be mild to severe. They also come with their own set of risks if not treated properly.

Can strep throat or tonsillitis go away on its own?

If your tonsillitis is caused by a viral infection, it will likely go away on its own. Strep throat is caused by a bacteria called group A streptococcus. Treatment with antibiotics may speed symptom resolution and decrease the time you are contagious.

How do I know if my sore throat is tonsillitis?

To receive a diagnosis, your doctor will take a history and do a physical exam. Your doctor may decide a strep test is needed and if so, perform one.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

How do I know if I have strep throat or tonsillitis?

If your doctor suspects tonsillitis or strep throat, they will swab the back of your throat to take a sample. They can use a rapid strep test to determine if you are infected with strep bacteria. They can get results within a few minutes.

Is tonsillitis and strep throat treated the same?

Treatments and Prevention Bacterial infections, including strep throat, are usually treated with antibiotics. For viral cases of tonsillitis, treatment is with over-the-counter pain relievers like acetaminophen (Tylenol) and NSAIDs (ibuprofen, Advil, Motrin).

Is tonsillitis caused by strep throat?

Tonsillitis is most often caused by common viruses, but bacterial infections also can be the cause. The most common bacterium causing tonsillitis is Streptococcus pyogenes (group A streptococcus), the bacterium that causes strep throat. Other strains of strep and other bacteria also may cause tonsillitis.

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