Overview
Strep throat and tonsillitis both cause a sore throat and involve inflammation in the throat area, but their causes differ. Strep throat is a bacterial infection caused by Streptococcus pyogenes, while tonsillitis refers to inflammation of the tonsils, which can be caused by either viruses or bacteria. All strep throat is tonsillitis, but not all tonsillitis is strep. Strep throat typically presents with sudden severe sore throat, fever, and no cough, while viral tonsillitis may include cough and congestion.
Disease Summaries
Strep Throat: Strep throat is a bacterial infection caused by Streptococcus pyogenes (Group A Streptococcus). It primarily affects the throat and tonsils, leading to sudden and severe sore throat, pain with swallowing, fever, and swollen lymph nodes. It is most common in children and spreads through respiratory droplets. Unlike viral sore throats, strep throat typically does not include coughing or nasal symptoms.
Tonsillitis: Tonsillitis is infection of the tonsils and pharynx (back of the mouth), either by viruses or bacteria.
Comparing Symptoms
Overlapping Symptoms
- Sore throat
- Pain while swallowing
- Swollen, red tonsils
- Fever
- Headache
Strep Throat Specific Symptoms
- Sudden onset sore throat
- High fever
- Swollen lymph nodes in the neck
- No cough or runny nose
- White patches or streaks of pus on tonsils
Tonsillitis Specific Symptoms
- Sore throat with cough and congestion (if viral)
- Hoarseness or loss of voice
- Mild fever
- Red, swollen tonsils, sometimes with blisters or ulcers
- Fatigue and general malaise
Treatment Approaches
Strep Throat Treatment Approaches
Strep throat is treated with antibiotics, usually penicillin or amoxicillin, to reduce symptoms, prevent complications, and limit contagion. Symptom relief may include over-the-counter pain relievers (acetaminophen or ibuprofen), hydration, and throat soothing remedies. Patients are typically no longer contagious after 24 hours of antibiotic therapy.
Tonsillitis Treatment Approaches
This condition may improve without treatment, especially if caused by viruses. The doctor may prescribe pain relievers, and in some cases antibiotics to fight a bacterial infection. Ensuring proper hydration is important as pain makes swallowing and drinking difficult.
Reviewed By:

Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.

Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Apr 29, 2025
Following the Medical Content Editorial Policy
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Buettner, R., Schwermer, M., & Ostermann, T. (2023). Complementary and alternative medicine in the (symptomatic) treatment of acute tonsillitis in children: A systematic review. Therapies in Medicine.
https://www.sciencedirect.com/science/article/pii/S0965229923000274Bochner, R. E., Gangar, M., & Belamarich, P. F. (2017). A clinical approach to tonsillitis, tonsillar hypertrophy, and peritonsillar and retropharyngeal abscesses. Pediatrics in Review.
https://publications.aap.org/pediatricsinreview/article-abstract/38/2/81/31836Eroğlu, A., Suzan, Ö. K., Kolukısa, T., & Kaya, Ö. (2024). The relationship between group A streptococcus test positivity and clinical findings in tonsillopharyngitis in children: systematic review and meta-analysis. Infection.
https://link.springer.com/article/10.1007/s15010-024-02395-7