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Can You Get Strep Throat Without Tonsils?

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Can You Get Strep Throat Without Tonsils?

writtenByWritten by: Andy Wong
Andy Wong

Andy Wong

Andy is the Chief Marketing Officer at PlushCare. He's passionate about advancing healthcare solutions and improving access to care via health technology.

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reviewBy Reviewed by: Dr. Katalin Karolyi
Reviewer

Dr. Katalin Karolyi

Katalin Karolyi, M.D. earned her medical degree at the University of Debrecen. After completing her residency program in pathology at the Kenezy Hospital, she obtained a postdoctoral position at Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida.

February 17, 2021 Read Time - 10 minutes

Could You Still Get Strep Throat Without Tonsils?

Your tonsils, known as palatine tonsils, are two masses of soft tissue found in the back of your throat. They are composed of a tissue similar to lymph nodes covered with a pink mucus membrane. The membrane features pits known scientifically as “crypts.”

Your tonsils are involved in the lymphatic system and are designed to keep you from getting infections. However, tonsils themselves can become infected or otherwise require removal, which generally does not have any effect on your health or immunities.

One common belief is that no tonsils means fewer infections. After all, your tonsils can’t get infected if they are not even there in the first place. One of the most common ailments of the throat is streptococcal pharyngitis, more commonly known as strep throat. It accounts for about 5-20 percent of all sore throats in adults. Even without tonsils, children can still get strep throat, but get it less frequently as they get older.

Learn more about how strep throat works and how removing your tonsils can reduce your risk of infection.

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What is Strep Throat?

Strep throat is a bacterial infection affecting the tonsils and mucus membranes that line the back of the throat, causing inflammation and swelling that leads to a sore throat. It is more common in school-aged children 5 to 15 years old. In fact, it is estimated that 15% of them get strep throat every year.

What Causes Strep Throat?

Strep throat is caused by a bacteria known as Group A Streptococcus, also known as Streptococcus pyogenes. When the bacteria enters your system, it invades the pharyngeal tissue and triggers an inflammatory reaction in your tonsils and throat. Group A Streptococcus can be found in the throat and on the surface of your skin and is associated with a wide range of other diseases, including:

  • Skin infections like impetigo and cellulitis
  • Toxic shock syndrome
  • Scarlet fever
  • Rheumatic fever

Group B Streptococcus is another type of streptococcal bacteria, but it is rarely the cause of strep throat. Instead, it is more associated with bacterial pneumonia, meningitis, and certain blood infections.

The Spread of Strep Throat

Strep throat is contagious and is usually transmitted via direct contact with the saliva or nasal secretions from someone who is infected with or carrying the bacteria.

This typically happens in the form of airborne water droplets expelled when a person sneezes or coughs, which is why strep throat is much more common in areas with large numbers of people in close proximity, like schools, daycare centers, and college dorms. It can also be contracted from objects that may have the bacteria on them, like phones, utensils, doorknobs, keyboards, and towels.

While the bacteria can also be transmitted via food, foodborne outbreaks are a much less common form of transmission.

The Symptoms of Strep Throat

The severity and types of symptoms of strep throat can differ from person to person based on age and general health. Some people may carry the bacteria but show no symptoms, though most people’s symptoms will range from mild to severe. These symptoms happen within the first 5 days after initial exposure to the bacteria.

The most prominent symptom of strep throat in adults and children is a raw, red sore throat, but the first symptom is usually a high fever of about 101 degrees Fahrenheit.

Other common strep throat symptoms include:

  • Red or white patches on your throat and tonsils
  • Sore throat
  • Tiny red dots on the roof of your mouth
  • Headache
  • Chills and fatigue
  • Loss of appetite
  • General malaise
  • Swollen lymph nodes along your neck
  • Difficulty swallowing

Certain symptoms suggest that you contact the doctor immediately, including:

  • Swollen, tender lymph nodes on the neck with sore throat
  • Sore throat with a rash
  • Drooling or inability to swallow your saliva
  • Making noises when you breathe or problem when breathing
  • Inability to swallow food or liquids

While many of these symptoms are associated with strep throat, they may also point to more severe problems, including tracheitis and a retropharyngeal abscess.

Strep Throat and Your Tonsils

A study found that kids who had their tonsils removed after having strep throat were less likely to contract throat infections again. Results from the study suggest that children who had not gotten their tonsils removed were more likely to get throat infections sooner and more often during the first year than those who had undergone tonsillectomies.

However, removing the tonsils will not eliminate your chances of getting strep throat. You can still get strep throat. The infection is not localized to the tonsils alone. Tonsillectomies are better suited for children who have recurring strep throat to reduce the frequency and severity of symptoms.

Your child is considered to have recurring strep throat if they have seven or more severe throat infections in a single year. Severe throat infections are defined by exhibiting at least one of the following symptoms:

  • Difficulty with breathing or swallowing due to enlarged tonsils
  • Red rash appears
  • An oral temperature of at least 101 degrees Fahrenheit with a severe sore throat for longer than 1-2 days

As effective as removing the tonsils may be, most kids will stop having recurring strep throat infections as they get older. As common and generally safe as they are, tonsillectomies are still surgeries, meaning they can come with potential complications.

There are risks with bleeding and anesthesia as well as the loss of school days for recovery. It is a serious consideration. You should weigh the risks and benefits and consult your doctor before you commit to a decision.

Diagnosing Strep Throat

Sore throats are actually fairly common in a variety of diseases. Many sore throats are often a result of viral infections, like those resulting in the cold or flu. If you are coughing or sneezing or have a runny nose along with your sore throat, you are likely suffering from a viral infection. Aside from over-the-counter medications to ease symptoms, most viral infections should go away on their own without the need for treatment.

The only true way to know if you have strep throat is to consult your doctor for a professional diagnosis. Thankfully, diagnosing strep throat is fast, easy, and painless. Starting with a physical exam, your doctor will take a sample of fluids from the back of your throat using a cotton swab. The fluids will then undergo a rapid strep test, which is designed to indicate the presence of group A Streptococcus. As the name suggests, this test is fast and you should have results within 8-20 minutes.

However, the rapid strep test cannot determine all forms of the bacteria, so even if the tests show negative results, your doctor will send the fluid samples to the lab just in case. At the lab, doctors can create a throat culture and determine if your symptoms are caused by a streptococcal bacteria. While this test is more definitive, it will take longer for you to get the results, usually up to 48 hours.

Treating Strep Throat

While removing your tonsils is a potential treatment for recurring strep throat in kids and adults, general cases of strep throat are usually treated with a course of antibiotics. Antibiotics are meant to stop the spread of the bacteria to others and within your own body. They will also reduce your fever and help you feel better faster. The most common antibiotics prescribed for strep throat are penicillin and amoxicillin, but there are several types of antibiotics available.

Most people will feel better and stop being contagious after the first 24 hours of treatment. Those who do not take antibiotics can still spread the bacteria  even if they feel better and their noticeable symptoms have subsided.

It is important to complete the full course of antibiotics as prescribed by your doctor to make sure that the bacteria are completely killed from your system. Some people mistakenly stop taking antibiotics as soon as their symptoms get better. This may trigger a relapse, which can cause symptoms to return in more severe forms.

Not taking the antibiotics as prescribed may also create bacteria that are immune to common antibiotics, which forces the usage of more powerful antibiotics, increasing the risk of growing antibiotics-resistant bacteria to the new drugs too

Along with antibiotics, your doctor will likely prescribe over-the-counter pain relievers, like acetaminophen and ibuprofen, to reduce the fever and help you cope with the pain. Avoid giving aspirin to children and toddlers with strep throat as it has been linked to Reye’s syndrome, a disorder that can cause damage to a child’s brain and liver.

Home Remedies and Care

To improve symptoms and make yourself more comfortable, try these at-home treatments:

  • Stay hydrated and drink plenty of fluids. Fevers can increase fluid loss, while sore throats can reduce your fluid intake, which doubles your risk of dehydration.
  • Avoid coffee, which acts as a diuretic and often encourages water loss. You should also generally stay away from acidic beverages, like lemonade and orange juice, which may only further irritate your throat.
  • Drink colder fluids to numb your throat.
  • Drink warm fluids, including tea and soup, to soothe your throat.
  • Turn on a cool-mist humidifier to ease your breathing, but make sure you clean the humidifier as advised in the manual. A dirty humidifier will only spread bacteria and make your condition worse.
  • Suck on throat lozenges to calm any irritation in your throat.
  • Gargle a cup of water containing a half teaspoon of salt. This will help to flush out some of the bacteria in your throat and ease some of the pain you have.
  • Get plenty of sleep. Extra rest can encourage more rapid recovery.

Preventing Strep Throat

Predicting the disease can be difficult considering many people may carry the bacteria without even knowing it, so completely preventing strep throat is close to impossible. Wash your hands frequently when you are out and about, especially before you eat. If you know someone has strep throat, you may consider avoiding them until they have received treatment or until their symptoms have subsided.

In terms of preventing the spread of strep throat to others when you have it, you have a lot more control. The best thing you can do is stay at home until you have received treatment or otherwise feel better. If you must go out, consider wearing a facemask.

Cough into a tissue, handkerchief, or the inside of your arm. Wash your hands, and never share food, drinks, utensils, or other objects that may have your germs on them. You should also consider changing out your toothbrush when you get better to prevent any reinfection.

If you experience any serious complications or discomfort, or your symptoms worsen after a few days, you may require prescription medication. Consult your physician, visit urgent care, or book an appointment with an online doctor.


Read More About Strep Throat


Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

CDC. Strep Throat. Accessed on January 29, 2021 at https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Mayo Clinic. Strep Throat. Accessed on January 29, 2021 at https://www.mayoclinic.org/diseases-conditions/strep-throat/diagnosis-treatment/drc-20350344

Mayo Clinic. Strep Throat Symptoms. Accessed on January 29, 2021 at https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338

Ncbi.nlm.nih.gov. Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review. Accessed on February 17, 2021 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5260157/pdf/PEDS_20163490.pdf

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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