Can You Get Strep Without Tonsils?

Dealing with strep throat can be painful, especially if you or your child suffer from recurring infections.

So you may think that removing your or your child’s tonsils is the solution.

Yet while this elective surgery (called a tonsillectomy) can reduce the risk of getting strep throat and experiencing severe symptoms, it doesn’t entirely eliminate the possibility of coming down with the bacterial infection.

Read on to learn all about strep throat, including the symptoms, how doctors diagnose the infection, and how tonsils sometimes (but not always) factor in.

You’ll also learn how to treat and prevent strep throat whether or not you have tonsils, plus when to see a doctor about a sore throat.

What Is Strep Throat?

Strep throat (also known as streptococcal pharyngitis) is a painful bacterial infection of the throat and tonsils caused by the bacteria A Streptococcus (or group A strep).

People of any age can get strep throat, but it occurs most frequently in children 5-15 years old.

It also commonly spreads in late autumn and early spring, though it’s possible to get strep throat anytime of year.

Strep throat causes sore throats that come on suddenly and often other symptoms such as painful swallowing, fever, and red or white spots on the back of the roof of the mouth.

Possible causes

Strep throat is caused by bacteria called group A strep.

This bacteria is highly contagious and spreads easily between people via fluids spread through coughing, sneezing, infected surfaces, and close contact with someone infected. 

Common Symptoms of Strep Throat

It takes about 2-5 days after close contact with either group A strep bacteria or someone infected with strep throat for symptoms to set in.

Most times, strep throat symptoms are mild, but they can also be very painful.

The most common symptoms of strep throat are:

• Sore throat that comes on quickly
• Pain when swallowing
• Red, swollen tonsils
• Small red or white spots on the back of the roof of the mouth
• Tender, enlarged lymph nodes
• Fever
• Headache
• Rash
• Nausea or vomiting (more common in younger children)
• Body aches

Cough is typically not a symptom of strep throat.

Instead, a sore throat with a cough is usually a sign of a viral infection.

How to Diagnose Strep Throat

The only way to know for certain if you have strep throat is through a test performed by a healthcare provider.

Most often doctors do a rapid antigen test: They gently swab the back of the throat to collect a sample that’s checked for the presence of group A strep bacteria.

Results from a rapid strep test take about 20 minutes, so most providers are able to confirm a diagnosis and prescribe treatment in the same visit.

Strep Throat and Tonsils: How They’re Related

Most people are born with two tonsils.

These lumps of lymphatic tissue located at the back of the throat help the immune system clear infections and balance the body’s fluids.

They also work to trap germs that enter the body through the mouth and nose.

Because strep throat is an infection of the throat and tonsils, having tonsils puts one at a higher risk of developing strep throat.

But it’s still possible to get strep throat if you’ve had your tonsils surgically removed through a procedure called tonsillectomy.

Healthcare providers sometimes consider tonsillectomies for children who experience recurrent cases of strep throat (more than seven times per year).

Though this doesn’t guarantee that they won’t develop future cases of strep throat, it often helps reduce the frequency and severity of strep throat infections.

Treatment for Strep Throat

Because strep throat is a bacterial infection, oral antibiotics are the most common and effective treatment.

These medications reduce the severity and duration of symptoms and also help limit the spread of the infection.

In most cases, someone with strep throat starts to feel relief within 1-2 days of starting antibiotic treatment.

Penicillin and amoxicillin are the most common antibiotics used to treat strep throat. For people allergic to penicillin and penicillin-based antibiotics, doctors typically prescribe cephalexin, clindamycin, or azithromycin.

Keep in mind that antibiotics do not work for viruses.

That’s why it’s important to see your doctor if you are uncertain of the cause of a sore throat.

Preventing Strep Throat

Whether or not you have tonsils, you can take simple actions to help prevent strep throat:

• Wash your hands frequently: It’s important year-round and especially during strep season to regularly wash your hands with soap and water. If you can’t, use an alcohol-based hand sanitizer to clean your hands.

• Practice good hygiene: Cover your nose and mouth when coughing and sneezing, and don’t share personal items such as water bottles and food utensils.

• Limit contact with people who are sick: When possible, avoid direct contact with someone while they are infected with strep throat.

When to See a Doctor

If left untreated, strep throat can pose some serious risks, including:

• Tonsillitis
• Middle ear infection (otitis media)
• Sinus infection (sinusitis)
• Meningitis
• Kidney problems
• Rheumatic fever
• Pediatric autoimmune neuropsychiatric disorder (PANDAS)

So it’s important to see a healthcare provider as soon as possible if you have symptoms of strep throat.

If your doctor confirms the diagnosis, they can prescribe the right antibiotic prescription to clear the infection.

If your symptoms persist two days after starting the medication, let your doctor know.

How K Health Can Help 

Did you know you can get affordable primary care with the K Health app?

Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.