“I have a sore throat. Is it strep throat or something else?” There are many different reasons your throat might be feeling sore. Between allergies, environmental elements, viruses, bacteria, post-nasal drip from a cold, there are a lot of reasons you might be in pain. In this article, we’ll look at two different sore-throat suspects: Strep throat and herpes esophagitis, which is a herpes simplex virus (HSV) infection in your throat. 

So, is it herpes esophagitis, or is it strep throat? That can be a tricky question to answer since the two mimics each other in the presentation of symptoms. However, there are specific differences between herpes esophagitis and strep throat. 

Differences between strep throat & herpes 

1. Bacterial vs. viral. Strep throat and herpes esophagitis is the organism behind each infection. Strep throat is bacterial. It is caused by a bacterium called Streptococcus pyogenes belonging to Group A beta-hemolytic Streptococci (GAS). Strep throat is considered the most common form of bacterial Sore throat, according to the College of Family Physicians. Herpes esophagitis is a viral infection caused by a virus called herpes simplex virus (HSV), the second most common cause of viral esophagitis.
2. Risk factors for each specific infection. Strep throat primarily affects school-aged children between 5 and 15 years of age and spreads quickly in classrooms and daycares. Additionally, Strep throat cases tend to surge in winter and decrease in summer.  Herpes esophagitis primarily affects a different group of patients, including patients with a history of chemotherapy treatment, hematological malignancy patients, HIV patients, diabetes, and patients with autoimmune diseases. Of course, these risks vary by person.
3. Symptoms are different. They may share a few common characteristics like difficulty swallowing, but herpes esophagitis is a disease of the esophagus and would typically also include vomiting blood, cold sores, and, less frequently, fever. On the other hand, strep throat is distinguished by fever and enlarged lymph nodes, and a red throat, typically with white pus.
4. Diagnoses are different. Based on the patient’s symptoms, physicians use different investigations to diagnose the presence of strep throat-causing proteins. Physicians usually use a rapid strep throat test, AKA rapid antigen detection testing (RADT) for strep throat. This test can also be performed at home using a readily available home strep test kit. The approach involves using a throat swab to detect the presence of strep throat bacteria. To diagnose Herpes esophagitis, doctors need to look inside the esophagus using a small camera. This is called an endoscopy procedure. It helps doctors look at the amount of damage that the HSV virus leaves inside the esophagus. The doctors can also use a throat swab to detect the virus using molecular methods and cultures.
5. Treatment is different. Strep throat and herpes esophagitis are treated differently. Although sore throats generally resolve on their own and don’t require treatment other than symptom management, Strep throat requires a particular course of treatment with oral antibiotics like amoxicillin. If not treated, strep throat can potentially lead to deadly complications in the heart and kidneys. On the other hand, herpes esophagitis can be treated with over-the-counter (OTC) painkillers to alleviate the pain. Additionally, doctors can prescribe antiviral agents to treat herpes esophagitis. Herpes esophagitis can be treated within days, but it can also lead to severe complications like esophageal perforation.

In summary, strep throat and herpes esophagitis can mimic each other and can both cause a sore throat. Understanding the different symptoms of strep throat and a sore throat might help differentiate between them, which will lead to a quick diagnosis and a better chance of treatment.

How Effective Are Home Strep Tests?

In the beginning of strep throat, the first thing to do is to identify if you have signs of a strep throat infection. This can be effectively done using strep throat test kits. You can order any kit from a reliable brand like Checkable Medical. The at-home testing kit can quickly diagnose the proteins of strep-causing bacteria in under three minutes so that you can receive strep throat treatment as soon as possible. 

No more trying to find an appointment or waiting in long lines at the clinic. Get accurate strep throat test results quickly without compromising quality.