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===Differential diagnosis=== {{See also|Acute pharyngitis}} As the symptoms of streptococcal pharyngitis overlap with other conditions, it can be difficult to make the diagnosis clinically.<ref name=Review09/> Coughing, nasal discharge, [[diarrhea]], and [[conjunctivitis|red, irritated eyes]] in addition to fever and sore throat are more indicative of a [[viral sore throat]] than of strep throat.<ref name=Review09/> The presence of marked lymph node enlargement along with sore throat, fever, and tonsillar enlargement may also occur in [[infectious mononucleosis]].<ref name="pmid15508538">{{cite journal | author = Ebell MH | title = Epstein-Barr virus infectious mononucleosis | journal = Am Fam Physician | volume = 70 | issue = 7 | pages = 1279β87 | year = 2004 | pmid = 15508538 | url = http://www.aafp.org/afp/20041001/1279.html | url-status = live | archive-url = https://web.archive.org/web/20080724055725/http://www.aafp.org/afp/20041001/1279.html | archive-date = 2008-07-24 }}</ref> Other conditions that may present similarly include [[epiglottitis]], [[Kawasaki disease]], [[acute retroviral syndrome]], [[Lemierre's syndrome]], [[Ludwig's angina]], [[peritonsillar abscess]], and [[retropharyngeal abscess]].<ref name=Got2018>{{cite journal |last1=Gottlieb |first1=M |last2=Long |first2=B |last3=Koyfman |first3=A |title=Clinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis Mimics. |journal=The Journal of Emergency Medicine |date=May 2018 |volume=54 |issue=5 |pages=619β629 |doi=10.1016/j.jemermed.2018.01.031 |pmid=29523424|doi-access=free }}</ref>
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