Signs and symptoms of strep throat can include: 1  Throat pain that usually comes on quickly. 2  Painful swallowing. 3  Red and swollen tonsils, sometimes with white patches or streaks of pus.  Tiny red spots on the area at the back of the roof of the mouth (soft or hard 1  palate) Swollen, tender lymph nodes in your neck. 2  Fever. Headache.  Rash.