Sore throat in Puerto Rico: strep or virus, and when you need a test
A sore throat in Puerto Rico, as anywhere, is usually viral and gets better on its own in about a week. Sometimes it is strep, a bacterial infection treated with antibiotics, but strep can only be confirmed with a rapid test or throat culture done in person. By video, the doctor can tell you whether you need a strep test and help with relief. If you can’t breathe well or swallow your saliva, go to the ER.
Can we help by telehealth? Sometimes: it depends on the evaluation.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Trouble breathing
- Can’t swallow your own saliva, or a child is drooling
- Blood in your saliva or phlegm
- Signs of dehydration: very little urine, dry mouth, dizziness
Help lines:
- 911 — Emergencies
- 1-800-981-0023 — Línea PAS (mental-health crisis line)
- 988 — Suicide & Crisis Lifeline
- 1-800-222-1222 — Poison Help
Common causes of a sore throat
The viruses that cause colds and flu are the most common cause of a sore throat. Other causes include group A strep bacteria, allergies and smoke.
These signs point to a virus rather than strep: cough, runny nose, hoarseness and pink eye. If your sore throat comes with a cold, it is most likely viral.
Sore throat symptoms: virus or strep?
Strep throat is most common in children aged 5 to 15, but anyone can get it. It tends to start suddenly and cause:
- A sore throat that hurts to swallow
- Fever that starts suddenly
- Red, swollen tonsils, sometimes with white patches or pus
- Swollen, tender glands in the neck
- Headache, nausea or feeling generally unwell
- Sometimes a rough, sandpaper-like rash (scarlet fever)
Do I need a strep test?
Many causes of sore throat look the same, so strep can only be confirmed with a test: a rapid test using a throat swab, or a throat culture. It cannot be confirmed by video or by looking at a throat on a screen.
We do not do strep tests by video. If the doctor suspects strep, she will tell you to get tested in person, at a medical office, an urgent care center or, where she considers it appropriate, with a lab order. If the test is positive, strep is treated with an antibiotic taken for the full course.
If your symptoms clearly point to a virus (cough, runny nose, hoarseness), Infectious Diseases Society of America (IDSA) guidelines say testing is usually not needed and an antibiotic would not help.
What happens in the video visit
The doctor asks how long your throat has hurt, whether you have fever, cough or a runny nose, whether you can swallow fluids and saliva, and whether anyone at home has strep. In good light she may ask you to show your throat and neck on camera, though that does not replace a test.
She then tells you whether you can keep caring for yourself at home, whether you need a strep test, or whether you should be seen in person. If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances. Read why an antibiotic isn’t always prescribed.
Sore throat in children: strep needs a test
In babies, toddlers and preschoolers, a sore throat is most often caused by a virus. Strep is rare before age 3, and IDSA guidelines say children under 3 are not routinely tested for strep.
Children over 3 with a very sore throat, fever, swollen neck glands and pus on the tonsils, without cough or runny nose, need an in-person strep test. If a rapid test is negative in a child or teen, a throat culture is recommended to confirm it.
Take your child to the ER if they are struggling to breathe, can’t swallow their saliva, or are drooling. A child with strep can go back to school or daycare once they have no fever and have taken the antibiotic for at least 12 to 24 hours. We see children from 6 months old, with a parent or legal guardian on camera. A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs medical care right away. The doctor is not a pediatrician; see video visits for children.
Sore throat relief at home
Most sore throats get better on their own within a week. In the meantime:
- Suck on ice chips or ice pops, or sip warm drinks such as tea with honey.
- Gargle with warm salt water several times a day (half a teaspoon of salt in a cup of water).
- Use a cool-mist humidifier.
- Take acetaminophen or ibuprofen as the label or your doctor directs. Do not give aspirin to children or teens.
- Do not give honey to babies under 1, or lozenges to young children, who can choke on them.
When to be seen in person or go to the ER
Get medical care if you have:
- Trouble breathing or swallowing, or drooling in a young child.
- Blood in your saliva or phlegm.
- Signs of dehydration.
- Swollen, painful joints, or a rash.
- Symptoms that get worse after a few days or last more than a week.
- Fever, pain on swallowing and pus on the tonsils without a cough: you need a strep test.
Getting a sore throat checked in Puerto Rico
An online doctor visit costs US$79 and is for patients who are physically in Puerto Rico, including visitors. If you need an in-person test, we tell you during the visit and you can get tested wherever is most convenient on the island.
A sore throat with fever can also be part of the flu or COVID-19. If you also have congestion and facial pain, see sinus infection.
Video visit: US$79 · Pay by card · See the price and what is included
Before you book
- You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
- We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
- Real-time video only; we do not do phone-call visits.
- We do not prescribe controlled substances.
Frequently asked questions
- How can I tell if my sore throat is strep?
- You can’t be sure from symptoms alone. Sudden fever, pus on the tonsils and swollen glands without a cough make strep more likely, but it is confirmed with a rapid test or throat culture done in person.
- Can I get an antibiotic for a sore throat by video?
- Most sore throats are viral and an antibiotic won’t help. If the doctor suspects strep, she will direct you to an in-person test; antibiotics are used when a test confirms strep.
- How long does a sore throat last?
- Most get better on their own in about a week. If yours lasts longer, gets worse after a few days, or comes with trouble swallowing or breathing, get medical care.
Sources
- Sore Throat Basics (CDC) (accessed 2026-09-30)
- Strep Throat (CDC) (accessed 2026-09-30)
- Clinical Guidance for Group A Streptococcal Pharyngitis (CDC) (accessed 2026-09-30)
- Strep throat (MedlinePlus, NIH) (accessed 2026-09-30)
- Clinical Practice Guideline for Group A Streptococcal Pharyngitis: 2012 Update (IDSA) (accessed 2026-09-30)
- The Difference Between a Sore Throat, Strep & Tonsillitis (AAP, HealthyChildren.org) (accessed 2026-09-30)