What characterizes streptococcal pharyngitis based on symptoms?

Streptococcal pharyngitis, commonly known as strep throat, is primarily characterized by the presence of pharyngotonsillar exudates. These can appear as white or yellowish patches on the tonsils and the back of the throat, which result from the inflammatory response to the bacterial infection. Accompanying symptoms often include a sore throat, fever, and swollen lymph nodes, but the visible exudates are a hallmark finding that helps differentiate strep throat from viral pharyngitis and other causes of sore throat.

In contrast, severe cough is more typically associated with viral infections or bronchial conditions and is not a common symptom of strep throat. A skin rash can occur in certain conditions like scarlet fever, which is caused by streptococcal infection, but it is not a defining feature of streptococcal pharyngitis itself. Persistent headache can occur with various illnesses but is not a key symptom that specifically characterizes strep throat. Thus, the presence of pharyngotonsillar exudates is the most indicative symptom for diagnosing streptococcal pharyngitis.