What feels like strep but isn't strep is usually a viral infection (like the common cold, flu, or COVID-19), Mononucleosis (Mono), or sometimes allergies or GERD, causing similar symptoms like throat pain, redness, and white patches, but without the specific strep bacteria. These viral causes often come with other symptoms like coughing or runny nose and don't respond to antibiotics, unlike true strep.
Some common ones are rhinovirus (common cold), flu, adenovirus, and coronaviruses, like COVID-19. These typically lead to redness and rawness in the back of the throat. One virus that really mimics strep throat is the Epstein-Barr virus, the virus that causes mono.
Viral infections are a more common cause of sore throat than strep bacteria, so if strep tests are negative, a viral infection may be the culprit. Viral throat infections may include additional symptoms such as cough, runny nose or inflamed eyes.
Sometimes viral illnesses cause a sore throat that may be mistaken for strep throat. These include common cold viruses, coronavirus disease 2019 (COVID-19), influenza (the "flu"), croup, mononucleosis (“mono”), measles, and chickenpox.
Sore throat can be a symptom of strep throat, the common cold, allergies or other upper respiratory tract illness. Most sore throats will get better on their own within one week.
Most sore throats related to a viral infection go away within three to 10 days. If your sore throat lasts longer than this, it may be a symptom of a condition that requires prescription medications or other treatments your healthcare provider can recommend.
sore throat with swollen tonsils that may have white patches. swollen lymph nodes (glands) in the neck. being very tired.
Two frequent culprits, mononucleosis (mono) and strep throat, can look similar at first glance. Both cause throat pain, fatigue, and swollen glands, yet their causes and treatments couldn't be more different.
Chlamydia in the throat may also cause STD white spots on tonsils or in the back of the throat. If you have swollen tonsils and any other symptom that resembles a strep throat infection, it may be wise to still get tested for chlamydia.
The rapid strep test can give false-negative results even when strep bacteria are present. When the results of a rapid strep test are negative, many doctors recommend doing a throat culture to make sure that strep throat is not present.
A severe sore throat may be an indication of possible strep throat, a bacterial infection. Individuals who develop strep throat often have high fevers or pus on the tonsils; however, Ongkasuwan said many other viral infections may be associated with high fevers so she recommends visiting your doctor for a throat swab.
Strep throat and COVID-19 can both cause a sore throat. Strep and COVID-19 have different origins, which also causes them to require different treatment strategies. It's possible to have strep and COVID-19 at the same time.
Up to 3 in 10 children and 1 in 10 adults feeling sick with a sore throat due to a virus or other cause will test positive for group A strep. That means that people with a sore throat caused by a virus could also be positive for strep, even if it's not causing the symptoms.
Redness in the throat or mouth with white spots, similar to strep throat. Painless mouth sores. Lesions around the mouth that look like cold sores. Tonsillitis.
Throat appearance: Strep often shows red, swollen tonsils with white patches. A throat with mono may be red and swollen but usually lacks distinct white patches. Additional symptoms: Mono frequently causes swollen lymph nodes and an enlarged spleen, which are less common in strep.
Rheumatic fever is a complex disease that affects the joints, skin, heart, blood vessels, and brain. It occurs mainly in children between the ages of 5 to 15. It's an autoimmune disease that occurs after an infection with strep (streptococcus) bacteria. Strep infections include strep throat and scarlet fever.
Changes in the bacteria themselves may also play a role. The emergence of a new variant of Strep A, the so-called M1UK variant, was first reported in 2019 and linked to a marked increase in invasive infections, seasonal scarlet fever surges, and expression of a superantigen toxin.
Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. Often, the lymph nodes in the neck are swollen and painful.
Common Causes of a Sore Throat With No Other Symptoms
The Epstein-Barr Virus (EBV) has different stage descriptions, but generally involves Primary Infection, Latency, Reactivation (Lytic Cycle), and sometimes a chronic phase, moving from initial infection to lifelong dormant presence, periodic awakening with new symptoms, and potentially chronic active infection, often seen as different phases within the illness of mononucleosis (mono) like incubation, acute, and convalescent stages.
Red flags for a sore throat that need urgent care include difficulty breathing or swallowing, severe pain (especially on one side), drooling, inability to open your mouth fully, stiff neck, confusion, high fever with shivering, dehydration signs, or blood in saliva, as these can signal serious issues like airway obstruction, severe infection, or rare conditions needing immediate attention. See a doctor if it lasts over a week, recurs often, or if you have night sweats, unexplained weight loss, or a weakened immune system.
Throat lozenges, numbing sprays, and ibuprofen work quickly to reduce symptoms.
“If the test is negative, the sore throat is most likely caused by a virus,” Dr. Duong says. There are two types of tests for strep throat: Rapid strep test: A rapid strep test involves swabbing the throat and running a test on the swab.