Can You Get Strep Throat Without Tonsils?

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Causes of strep throat

Although viruses are the primary cause of a sore throat, strep throat is caused by bacteria called group A Streptococcus, which affects the tonsils and throat. You risk developing strep throat when you touch your eyes or nose after contracting these bacteria when someone with strep throat coughs or sneezes.

You can also contract the illness if you share food or beverages with someone with strep throat. You can also develop strep throat from touching surfaces infected with the group A Streptococcus bacteria.

People with or without tonsils are susceptible to a strep infection. However, people with tonsils are more likely to get strep throat. This is especially true for children and teens. The absence of tonsils reduces your chances of developing the infection and the severity of the symptoms.

Common symptoms of strep throat

Strep throat usually develops as a sore throat. Around two to five days after contracting strep throat, you may notice symptoms like:

  • Sore throat

  • Nausea 

  • Pain or difficulty when swallowing

  • Fever

  • Red and swollen tonsils, occasionally with pus-filled white areas or streaks

  • Tiny red patches on the roof of your mouth

  • Swelling of the neck’s anterior lymph nodes

  • Rashes

  • Headaches

Without tonsils, you may still experience these symptoms if you contract strep throat, but you obviously won't have swollen tonsils.

If your sore throat is caused by a virus rather than the strep throat bacteria, you are more likely to experience other symptoms like:

  • Runny nose

  • Hoarseness (your voice sounds raspy, breathy, or strained)

  • Cough

  • Conjunctivitis

Who is at risk of developing strep throat?

No one is immune to strep throat, but several conditions make it more likely that you'll contract this common infection. Children are more susceptible to strep throat than adults, especially kids aged 5–15.

Children under the age of three are rarely affected by strep throat. Adults at high risk of strep throat are parents of school-aged children and people who frequently come into contact with children.

The most frequent risk factor for strep throat is close contact with an infected person. For instance, the bacteria can spread to other household members if a family member has strep throat.

How is strep throat diagnosed?

Your doctor will ask about your symptoms, then perform a physical examination to identify the illness. To diagnose strep throat, they will swab your throat to test for the infection using the following:

  • A rapid strep test: This involves a throat swab that can reveal the presence of strep throat within minutes.

  • A throat culture: This test is used when your rapid strep test results are negative, but your doctor still believes you may have the illness. A throat culture can occasionally detect infections that the rapid strep test missed.

Doctors recommend a throat culture in children and teenagers because they are more likely to develop complications from untreated strep throat, such as rheumatic fever.

Adults are at reduced risk of developing rheumatic fever after a strep throat infection, so a throat culture is not typically required for them after a negative rapid strep test.

How is strep throat treated?

Since strep throat is a bacterial infection, antibiotics such as amoxicillin or penicillin are the usual treatment. Once you begin the treatment, you should expect a significant improvement within 48 hours. Antibiotics are commonly recommended to:

  • Reduce the severity of symptoms

  • Lower the risk of transmission

  • Help in preventing complications

Consult your physician if, after 48 hours of antimicrobial treatment, you don't feel better. Your sore throat may be due to a viral infection that can't be treated with antibiotics.

You can also try medicated throat lozenges since they can help relieve pain symptoms. Additionally, over-the-counter analgesics and painkillers like ibuprofen (e.g., Advil) may be used to control discomfort.

A tonsillectomy (removal of tonsils) may be recommended if you frequently develop strep throat, especially if you have the infection seven or more times in 12 months. Even though this treatment does not prevent you from getting strep throat, it may lower the number of strep infections and their severity.

How can you prevent strep throat?

Prevention is the best way to ensure you are safe from contracting strep throat. Always practice excellent hygiene and eat a balanced diet. This will help to strengthen your immune system against not only strep throat but other infections as well.

The lowdown

Strep throat is an infectious condition caused by bacteria. While antibiotics such as penicillin have proven effective in treating the infection, there are some circumstances (e.g. frequent recurrence) where a tonsillectomy may be advised.

Tonsil removal won't prevent future cases of strep throat, but it may help you experience fewer, less serious infections. Consult your doctor for a diagnosis or advice on the best course of action if you have recurring infections.

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