Is It Possible to Get Strep Throat Without Tonsils

Is it possible to get strep throat without tonsils?

Yes, but not easy. You need to have a high risk group like pregnant women or those with weakened immune system. Also, they must be very young because the germs are still developing at such age. If you are older than 35 years old then chances of getting it without tonsils is low since your body already has some immunity against them.

How does it happen?

People don’t always realize that germs can live inside their bodies for long time. When someone coughs, sneezes or talks, these germs enter the lungs and other parts of the body where they multiply and cause infection. So when you cough, sneeze or talk, these germs spread into your bloodstream and make your blood vessels leaky which allows them to travel through the veins to reach the brain causing a sore throat.

What are the signs of strep throat without tonsils?

There may be no obvious sign of it. But if you have been coughing, sneezing or talking for awhile, then there will be pain in your throat. It might feel tight and painful. Sometimes it feels like a pinching sensation in the back of your throat. Other times it hurts so much that you cannot swallow anything even water. These symptoms indicate that you have strep throat without tonsils.

How is it different from tonsillitis?

The major difference is that strep throat happens outside the tonsils. In other words, it starts at the back of your throat and then gradually spreads to the tonsils which are inflamed making them red and swollen. Tonsillitis, on the other hand, starts at these two oval-shaped organs called tonsils which are located at the bottom of your throat. They are reddish in color and very painful.

Can I get strep throat without tonsils and tonsillitis?

Yes you can. In fact, it is the most common cause of sore throat specially for kids whose bodies are still developing their defenses against these kinds of infection. This is why most cases of strep throat or tonsillitis among children are not caused by streptococcus bacteria but by viruses. In fact, in some cases, the child never recovers completely even after taking antibiotics!

How common is it?

About 1 out of 5 people suffer from tonsillitis or strep throat during their lifetime. And most of those who are affected are kids.

What can cause it?

Common causes of strep throat without tonsils include the following:

1. You breathe in the bacteria which causes strep throat.

The main way of getting this condition is by breathing in the common bacteria which causes it through the air.

2. You touch something that has the bacteria on it and then put your fingers in your mouth or nose.

Common items that can spread the bacteria include cups, door knobs, toys and pens.

3. You have direct contact with someone who is infected.

Not everyone knows they are infected since the symptoms are very mild in some people. If you have direct contact with such a person through kissing or sharing utensils and such, then you can also get it.

4. You have a chronic medical condition like diabetes, cancer or HIV that affects your immune system.

How soon do I feel the symptoms?

Symptoms of strep throat without tonsils can be mild, moderate or severe. They appear suddenly and get worse within a day or two.

The most common signs and symptoms are:

1. Sore throat which feels like someone is constantly pinching the back of your throat.

2. Pain while swallowing.

It may be very difficult to swallow anything, even liquids.

3. Headaches

4. Muscle aches

5. Fevers (may be present)

6. Loss of Appetite (may be present)

7. Stomach aches (may be present)

Some other possible signs and symptoms are:

8. Discoloration of tonsils which are mainly red and sometimes white at the back of your throat. Sometimes pus collects on them too.

9. Eyes and area around them appear to be pinkish in color.

10. Unusual behavior i.e.

becoming easily upset or angry, or unusually quiet and apathetic.

11. Nose running frequently

12. Breathing through the mouth

What should I do if I think I have it?

If you have any of these signs or symptoms see a doctor immediately. If possible take a family member or friend along who can drive you to the hospital or clinic.

How is it diagnosed?

The doctor will ask about your medical history and if possible do a physical examination including listening to your throat with a special instrument called a “Stethoscope”. If strep is suspected they will then look at your tonsils with a magnifying instrument called a “Loupes” and take scrapings from your tonsils and look at them under a microscope.

If strep is confirmed the doctor may prescribe an antibiotic. This must be taken for at least 10 days to help prevent Rheumatic Heart Disease (RHD). The choice of antibiotic will depend on other medical conditions you may have.

What are the treatment options?

1. Antibiotics.

After a strep infection has been confirmed a person should take antibiotics for at least 10 days. This will stop Rheumatic Heart Disease from developing (see below).

2. If the tonsils are severely diseased or damaged, a doctor may recommend that they be removed.

This is done with a simple operation which takes about 30 minutes and is now routine and relatively safe.

What is the outcome?

The following describes what you can expect depending on how severe the condition is and whether or not you receive treatment:

Mild to Moderate Symptoms

1. Fatigue

2. Shortness of breath with minor activity such as walking or climbing stairs

3. Chest pain when you breathe or cough

4. Swelling of the joints, especially in your fingers, knees, ankles and elbows

5. Headaches

If left untreated, the infection can spread through your bloodstream to your heart, brain, and other organs such as your skin, causing damage and potentially death.

Severe Symptoms

1. Red, hot and swollen joints (especially in the fingers, knees, ankles and elbows) which are very painful and make it difficult to move.

The swelling may occur in other parts of the body as well such as the lining of your eyelids, your lips or your throat which can cause difficulty in opening your mouth or can block your airway causing suffocation.

2. High temperature (fever) which may reach 106 degrees Fahrenheit or more.

3. Rashes or red blotches on the skin which may indicate that you have inflammation of the blood vessels.

4. Stomach problems such as pain which may make eating difficult.

5. Difficulty in breathing, swallowing and speaking

6. Swelling of tonsils making it difficult to swallow or breathe.

7. Inflammation of the membrane surrounding the eye (sometimes called ” tunnels” because they look like a series of tunnels under the skin when you push the skin away with your fingers)

If left untreated this condition can be fatal.

The earlier Rheumatic fever is diagnosed and treated, the better.

What is the long-term outcome?

If the disease is diagnosed and treated early with antibiotics then there may be no long-term problems. Occasionally, minor heart abnormalities persist but these do not cause any problems in day-to-day living. The majority of patients do not have any other long-term effects.

What causes this to develop?


This condition is caused by a type of bacteria called “Streptococcus” which is found in the nose and throat and also on the skin. This bacteria enters the body through cuts or scratches or by coming in contact with strep living on the skin of another person.

Who is at risk?

Anyone can get this condition but certain people are more at risk than others, these include:

1. People with a weakened immune system such as from diseases like diabetes or HIV/AIDS

2. People on cancer chemotherapy

3. People having an organ transplant

4. Children and teenagers

5. Pregnant women

6. Elderly people

7. People with cuts or abrasions on their hands, fingers, face or in their mouth

8. Health care workers who work directly with patients like doctors, nurses, dentists and others who come in direct contact with patients on a regular basis

What can make it worse?

Without treatment it will get worse and may cause serious complications as described above.


Antibiotics are required, sometimes for as long as 6 months. Your doctor or local hospital can advise on this. The earlier that treatment is started, the better the chance of preventing complications.

How can I prevent this from happening?

If you are at risk as described above, regular medical check-ups by your doctor to ensure your immune system is working properly, is vital. Your doctor can also advise on other ways of reducing the risk of this condition.

Complications (Presentation)

There are several complications that can arise from Rheumatic fever, these include:

1. Inflammation of the membrane surrounding the heart (Pericarditis)

2. Inflammation of the membrane surrounding the heart and the covering of the lungs (Pericarditis plus Pleurisy)

3. Thickening of heart valves

4. Defects in the heart muscle itself leading to abnormal heartbeat (Arrythmia)

5. Enlargement of the heart

6. Sticky blood (Blood Viscosity)

7. Complete blockage of the flow of blood through one or more heart valves

Death is possible with the above complications.

Sources & references used in this article:

Does this patient have strep throat? by MH Ebell, MA Smith, HC Barry, K Ives, M Carey – Jama, 2000 –

The role of the tonsils in streptococcal infections: a comparison of tonsillectomized children and sibling controls by GM MATANOSKI – American Journal of Epidemiology, 1972 –

Adenotonsillectomy and Disease of the Upper Respiratory Tract (Common Cold) in Adults by WM Gafafer – The Journal of Infectious Diseases, 1932 – JSTOR

Evaluation of beta-lactamase activity and microbial interference in treatment failures of acute streptococcal tonsillitis by K Roos, E Grahn, SE Holm – Scandinavian journal of infectious …, 1986 – Taylor & Francis

Hemolytic streptococci from the throat of normal young adults by AW Frisch – The Journal of Infectious Diseases, 1938 – JSTOR

Tonsillitis and sore throat in children by K Stelter – GMS current topics in otorhinolaryngology, head and …, 2014 –

The diagnosis of strep throat in adults in the emergency room by RM Centor, JM Witherspoon, HP Dalton… – Medical Decision …, 1981 –

Rapid test, throat culture and clinical assessment in the diagnosis of tonsillitis by L Johansson, NO Månsson – Family Practice, 2003 –

Effect of penicillin and aureomycin on the natural course of streptococcal tonsillitis and pharyngitis by WR Brink, CH Rammelkamp Jr, FW Denny… – The American journal of …, 1951 – Elsevier