Though commonly believed, it is not true that enlarged tonsils and white patches in the throat are only caused by strep. It is actually difficult to look in someone's throat and tell whether or not they have strep. Therefore, the best way to distinguish strep vs. viral sore throat is by the use of a culture. Diagnosis of bacterial sinusitis is made when people have facial pain and fever, or nasal discharge and cough without improvement for greater than ten days. People with ear infections usually have ear pain, fever, and a bulging red or yellow ear drum on exam.
Viruses cause most sore throats and coughs, and all colds.
There are more than 150 viruses that cause colds, so people can be infected many times over the course of their lifetime. Children average six colds per year, more if they are in daycare. Initial symptoms of a cold are nasal stuffiness and throat irritation. Within hours to days, watery nasal discharge, sneezing, and cough may occur. Other common complaints include low-grade fever, headache, decreased appetite, muscle aches, and fatigue.