It can be difficult to differentiate between strep throat, tonsillitis, and other causes of sore throat in children.  Sometimes the terms are interchangeable, but they are different things.

Strep throat is an infection caused by Streptococcus, a bacteria.  When a child has strep throat the tonsils are typically extremely inflamed. That inflammation can also affect the surrounding areas of the throat as well.  This causes a significantly sore throat for the infected child.

Alternatively, tonsillitis is simply the inflammation, or swelling, of the tonsils.  Tonsillitis could be caused by strep throat, among many other potential causes.

More About Strep Throat

Strep throat is a bacterial infection caused by Streptococcus pyogenes or group A Streptococcus.  It is a common infection among school-age children and adolescents.  Children with strep may have an incredibly painful sore throat, a fever over 102 degrees Fahrenheit, swollen lymph nodes in the neck, and pus on the tonsils.

The throat pain from strep throat tends to come on quickly and can make it difficult to swallow.  The tonsils of a child infected with strep may have white patches or streaks of pus.  You may also notice tiny red spots at the back of the roof of the mouth.

More About Tonsillitis

Tonsillitis is simply the inflammation of the tonsils, which are the two oval-shaped pads of tissue at the back of the throat.  Tonsillitis may include swollen tonsils, a sore throat, challenges swallowing, and swollen, tender lymph nodes on the sides of the neck.  The majority of tonsillitis cases are caused by a viral infection, but there are bacterial infections (like strep) that can also cause tonsillitis.

Other Causes of a Sore Throat

Children can get a sore throat from a variety of viral infections.  They can vary and include the common cold, Coxsackievirus (also referred to as Hand, Foot, and Mouth disease), and infections mononucleosis. All of these require a different course of treatment than a bacterial infection such as strep.

Treatments

Differentiating between tonsillitis, strep, and other causes of a sore throat can be difficult, so if your child is experiencing any of the above symptoms you should take them to the doctor to get an accurate diagnosis and treatment.  

Call your pediatrician if your child is experiencing a sore throat with a fever, a sore throat that doesn’t go away within a day or two, difficulty swallowing, extreme weakness, fatigue, or fussiness.  

If your child is experiencing difficulty breathing, extreme difficulty swallowing, or excessive drooling, you’ll want to seek immediate urgent or emergency care.

Most pediatric offices perform rapid strep tests that provide findings within minutes of testing.  If the rapid test is negative, the doctor may confirm with a throat culture. The throat culture involves touching the back of the throat and tonsils with a cotton swab, which is sent to a lab where it is applied to a culture dish and evaluated 24 hours later for the presence of the bacteria. 

The strep test is important to determine if the cause of the sore throat is bacterial or viral. A negative strep test often means the cause of the sore throat is most likely a viral infection, rather than a bacterial one. 

Bacterial infections are most often treated with an antibiotic, whereas a viral infection alone is not. Left untreated, there are complications that can arise from strep throat.  For this reason, it’s best to have your pediatrician determine the best course of action for your child’s symptoms.