Symptoms of a Streptococcus infection of the throat are related to the inflammation of the throat and surrounding tissues. It is not possible to determine whether a sore throat is due to strep infection without specialized testing. A severe sore throat is a common symptom, also some people may have a strep infection with only mild throat pain. Redness and swelling of the throat may be present. There may be white patches in the throat and on the tonsils if pus is present. Odynophagia (difficulty swallowing due to the pain) is common. People with strep throat may have fever and accompanying chills and muscle aches. Headache, nausea, and vomiting may accompany the infection. Another common symptom is tenderness and swelling of the lymph nodes on the sides of the neck. Toxins from the Streptococcus bacteria sometimes produce a characteristic skin rash that starts around the face and neck and spreads to the chest, abdomen, and groin. This condition occurs in about 10% of children with strep throat and is known as scarlet fever. There may be peeling of the skin of the fingertips along with the rash.