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Can You Get Strep Throat Without Tonsils?

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Can You Get Strep Throat Without Tonsils?

A common cause of sore and scratchy throat in kids, strep throat is a bacterial infection caused by group A Streptococcus bacteria. While surgical resection of the tonsils is successful in reducing throat infections, it doesn't guarantee long-term protection from strep throat or other throat infections. All it offers is a lowered risk of contracting strep throat!

A pain in the throat accompanied by pain while swallowing is often thought to be an indication of tonsils. But it can also be a symptom of strep throat, a term which is commonly used in place of a sore throat by many. Are tonsillitis, strep throat, and sore throat the same thing? If that’s what you have always assumed, you need to get your facts straight. It is also generally assumed that one cannot suffer from strep throat if there are no tonsils, that is after the person has had them removed through a tonsillectomy.

Let’s find out the difference between strep throat and tonsillitis and if one can exist without the other.

What Is Strep Throat?

Strep throat, more common in children than in adults, is a bacterial infection of the throat caused by group A Streptococcus bacteria (a.k.a group A strep). These bacteria can live in a person’s nose and throat without causing illness. Strep throat or streptococcal pharyngitis is a communicable disease. The bacteria spread through contact with droplets released into the air after an infected person coughs or sneezes. It is also possible to get this painful and agonizing disease from touching sores on the skin caused by group A strep.1

Severe throat pain, difficulty and pain while swallowing and a fever of 101°F (38.3°C) or higher are the most common symptoms of a strep throat. The bacteria also engulf the tonsils. A headache, mild neck stiffness, and gastrointestinal symptoms like anorexia, nausea, vomiting, and abdominal pain are some less common symptoms. These may be observed in roughly 35 percent to 50 percent of cases only.2

The back of your throat might appear bright red and beefy with white or yellow spots and you may also have swollen tonsils or lymph nodes.3

On another note, your partner or those around you might also be able to tell if you have strep throat just by your breath. Really? Can you smell strep throat? According to a research paper, the breath of those suffering from this bacterial infection is characteristically foul.4

So how can you be sure you have strep throat? The doctor will examine your throat and will probably ask you to undergo some tests. Available diagnostic tests include throat culture (commonly advised) and rapid antigen detection testing.5

Symptoms Of Tonsillitis

Tonsillitis, on the other hand, is an acute inflammation of the tonsils, which are two small masses of lymphoid tissue on either side of our throat. It can be caused by either viruses or bacteria, unlike strep throat which is a bacterial infection. Some of the most common symptoms of tonsillitis include fever, enlargement of the tonsils and regional lymph nodes, and difficulty swallowing.6

Tonsillitis is a common condition mostly seen in children and infrequently in adults. Normally, medication works to fix it but in the case of recurrent tonsillitis even after adequate antibiotic therapy, the tonsils need to be surgically removed (tonsillectomy).

Tonsillectomy is the most common operation performed on children. Those who have experienced at least three episodes of tonsillitis in each of three successive years; five episodes in each of two successive years; or seven episodes in one year are recommended the surgery.7

Can You Get Strep Throat If You Do Not Have Tonsils?

Tonsils are a major part affected by strep throat causing bacteria. But does that mean no tonsils, no strep throat? Not really. While tonsillectomy is successful in reducing throat infections, it most definitely doesn’t guarantee long-term protection from strep throat or other throat infections. All it offers is a lowered risk of contracting strep throat.

A study published in 2007 concluded that adults with a history of documented recurrent episodes of strep throat were less likely to have further streptococcal or other throat infections or days with throat pain if they had their tonsils removed. Only three percent of those who had undergone tonsillectomy had an episode of strep throat as opposed to 24 percent in the control group, which comprised of patients on the waiting list for a tonsillectomy.8

According to another research, 187 children severely affected with recurrent throat infection were observed. Of these, 91 were assigned randomly to either surgical or nonsurgical treatment groups, and 96 according to parental preference. The incidence of throat infection during the first two years of follow-up was significantly lower in the groups that went through surgery, than in the non-surgical groups. Despite surgery, throat infections did find a way to affect some. Third-year differences, although in most cases not significant, also consistently favored the surgical groups. But it is interesting to note that in each follow-up year, many subjects in the non-surgical groups had fewer than three episodes of infection, and most of these episodes were mild.9

How To Avoid Strep Throat

Strep throat is most commonly seen in children; however, adults are not immune to it either. The best way to avoid strep throat is to avoid contact with an infected person. Wash your hands regularly and avoid using the same utensils as the sick person.10

References   [ + ]

1. Worried your sore throat may be strep?. CDC.
2, 4. Ebell, Mark H., Mindy A. Smith, and Henry C. Barry. “Does This Patient Have Strep Throat?.” JAMA 284, no. 22 (2000): 2912-2918.
3, 10. Strep Throat. University of Michigan.
5. Choby, Beth A. “Diagnosis and treatment of streptococcal pharyngitis.” Am Fam Physician 79, no. 5 (2009): 383-390.
6. Tonsillitis. NCBI.
7. Paradise, Jack L. “Tonsillectomy and adenoidectomy.” Pediatric otolaryngology 2 (1996): 1054-1065.
8. Alho, Olli-Pekka, Petri Koivunen, Tomi Penna, Heikki Teppo, Markku Koskela, and Jukka Luotonen. “Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial.” BMJ 334, no. 7600 (2007): 939.
9. Paradise, Jack L., Charles D. Bluestone, Ruth Z. Bachman, D. Kathleen Colborn, Beverly S. Bernard, Floyd H. Taylor, Kenneth D. Rogers et al. “Efficacy of tonsillectomy for recurrent throat infection in severely affected children: results of parallel randomized and nonrandomized clinical trials.” New England Journal of Medicine 310, no. 11 (1984): 674-683.