Strep throat is a bacterial infection of the throat and tonsils. You can still get this infection if you've had your tonsils removed.
Although swelling—and sometimes even infectious oozing—of the tonsils can happen with strep throat, you can develop this infection in the lining of your throat with or without tonsils.
This article will explore what strep throat is like with and without tonsils, what causes this infection, and how it's treated.
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Strep Throat Without Tonsils
Swollen, red, and painful tonsils that are sometimes coated in a white film or streaks of pus are one of the many symptoms of strep throat. That doesn't mean removing your tonsils will prevent you from getting strep throat, though. If anything, you may have milder symptoms without the threat of red, swollen tonsils.
Strep throat is a bacterial infection that can affect many parts of your body. Without the presence of tonsils, the bacteria that causes this infection can colonize on a number of other surfaces. This can cause problems to develop outside of the throat like:
- A runny nose
- Headache
- Stomach pain
- Nausea
- Vomiting
- Skin rash
- Conjunctivitis (pink eye)
What Causes Strep Throat?
Strep throat is caused by group A Streptococcus (group A strep), a type of bacteria. There are several subtypes of this bacteria, but groups A and B are the most common.
Group A strep is responsible for several different diseases or infections, including:
- Strep throat
- Scarlet fever
- Impetigo
- Necrotizing fasciitis
- Cellulitis
- Toxic shock syndrome
- Rheumatic fever
- Post-streptococcal glomerulonephritis (a rare kidney disease)
Group B strep can also cause some strep throat infections, but this subtype more often causes things like:
- Blood infections
- Pneumonia
- Meningitis
- Urinary tract infections
- Skin infections
Strep Throat Symptoms
Symptoms of a strep infection in the throat outside of tonsil inflammation and pain include:
- Sore throat
- Pain with swallowing
- Fever
- Tiny red spots on the roof of your mouth
- Swollen lymph nodes at the front of your neck
Some people carry group A strep with no symptoms at all and are called carriers. While carriers may not get symptoms of a strep throat infection, they can still transmit the bacteria to others.
Strep Throat vs. Tonsillitis
Tonsillitis is an infection of the tonsils. This can be caused by bacteria, but most cases of tonsillitis are based on clinical examination alone and not bacterial testing. Strep throat can develop with or without inflammation of the tonsils and is almost always confirmed with laboratory testing for group A strep.
Strep Throat Treatment
Like most bacterial infections, strep throat is usually treated with antibiotics. Penicillin and amoxicillin are usually the first choice in treating a group A strep throat infection, but other antibiotics may also be used—usually, if you have an allergy to penicillins.
Although antibiotics will help you resolve the bacterial infection causing your sore throat, there are other things you can do to ease your symptoms while you wait for them to resolve. Supportive care for strep throat might include things like:
- Taking an over-the-counter (OTC) anti-inflammatory or pain reliever
- Gargling with warm saltwater
- Using throat lozenges or popsicles to soothe the throat
- Eating soft foods
- Avoiding foods that are acidic or spicy
- Drinking lots of water
- Getting plenty of rest to support your immune system
When to See a Healthcare Provider
Untreated strep throat can lead to a more complicated illness, such as scarlet fever. If you notice white or red spots at the back of your throat or the roof of your mouth, see your healthcare provider for testing and an antibiotic prescription.
If your tonsils become swollen and enlarged—whether from strep throat or another infection—seek emergency care right away, especially if you are having trouble breathing.
Strep Throat Prevention
There is no vaccine against strep throat, and you can get this infection repeatedly during your life.
The best way to keep from developing this infection is to avoid people who are sick and practice good hygiene. This might include:
- Frequent hand-washing
- Avoid touching your face, nose, or mouth
- Cover your mouth or nose with a tissue if you are sick
- Get proper nutrition and plenty of rest to keep your immune system strong
When Should I Consider Getting My Tonsils Removed?
The only two real clinical indications for having your tonsils removed is obstructive sleep apnea and repeated episodes of tonsillitis. Frequent bouts of strep throat may not be an indication since:
- Strep throat can develop even if you don't have tonsils.
- Even if you have your tonsils, you may not develop tonsillitis with a strep infection.
There is no real accurate way to tell whether the bacteria causing your strep throat is in your tonsils or the other areas of your throat as a whole. In fact, most diagnoses of tonsillitis are made without any bacterial testing at all.
If you experience frequent throat infections or are looking to minimize your healthcare provider visits and missed school or work due to throat infections, your healthcare provider may consider a tonsillectomy. This procedure will not prevent you from getting strep throat, but according to research, it was associated with a better quality of life for most people after their surgery.
Summary
Strep throat is a bacterial infection that often causes inflammation and pain in the tonsils, but you can still get it after your tonsils are removed. A tonsillectomy is usually performed to treat either obstructive sleep apnea or frequent throat infections of any type.
Strep throat needs to be treated with prescription antibiotics, so it's important to get an accurate diagnosis from a healthcare provider so you can get the medication you need. Untreated step throat could lead to serious complications.
A Word From Verywell
You might think your tonsils are to blame if you have repeated bouts of strep throat. In actuality, only bacteria is to blame, and it can affect many areas of your body outside the throat.
After a tonsillectomy, you can still get a strep throat infection. If you're considering a tonsillectomy, discuss the risk and benefits of this surgery with your healthcare provider. You should also talk to your healthcare provider if you frequently get strep throat or other infections.
Frequently Asked Questions
Does having your tonsils removed reduce your risk of strep throat?
No. You still have the same chances of developing strep throat, but your symptoms might seem milder without the added pain of swollen tonsils.
When should you consider having your tonsils removed?
The decision about whether to have your tonsils removed should be made between you and your healthcare provider. Obstructive sleep apnea and recurrent throat infections are really the only two clinical indications for this procedure. Your healthcare provider can discuss the specific risks and benefits of having your tonsils removed.
Will strep throat go away on its own?
Strep throat needs to be treated with antibiotics. Untreated strep throat may resolve in time, but you risk developing serious complications like scarlet fever and rheumatic fever.
By
Rachael Zimlich, BSN, RN
Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.
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