Strep Throat Without Fever

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
March 1, 2022

Strep throat is a highly contagious, very common bacterial infection that can cause discomfort in your throat and tonsils. Strep throat is caused by a bacteria called Streptococcus pyogenes or streptococcal bacteria.

It easily spreads from one individual to another through air particles, shared saliva, and infected surfaces.

 Different symptoms often accompany a strep throat infection. However, all strep throat cases don’t present the same symptoms. In this article, we’ll cover strep throat symptoms, risks and precautions, treatment for strep throat, what else it could be, and when to see a doctor. 

Strep Throat Without Fever: Is it Possible?

While fever is a common symptom of strep throat, it is possible to have strep throat without a fever.

When diagnosing you, a doctor may look for other common strep throat symptoms, such as a sore throat without a cough, swollen lymph nodes, white patches on the tonsils, and tiny red spots on the roof of your mouth. 

Concerned you have strep throat? Chat with a doctor through K Health.
get started

Strep Throat Symptoms

Strep throat symptoms are usually mild, but they can also cause much pain and discomfort.

Symptoms of strep throat usually set in about 2-5 days after contact or exposure. The most common symptoms include:

  • Sudden onset of sore throat: A sore throat that develops suddenly without accompanying cough can be a symptom of strep throat. The sore throat may be sensitive or scratchy. It may feel particularly painful when talking. 
  • Pain when swallowing: Some people experience pain or difficulty swallowing due to a sensitive or sore throat. 
  • Red and swollen tonsils with white patches: The tonsils are lumps of soft tissue located in the back of the throat. They help the immune system clear infection from the body. Strep throat infects the throat and tonsils. If you shine a flashlight into the mouth of an infected individual, you see that these lumps of tissue in the back of the throat look red. Sometimes they also appear to have white spots or streaks of white pus on them. 
  • Red spots on the roof of your mouth: Small red spots may appear on the roof of the mouth. They can also be seen by shining a flashlight into your mouth. 
  • Swollen lymph nodes: If you have strep throat, the lymph nodes on your neck may get tender and swollen. You can feel them on your neck, almost akin to a bean shape. 
  • Headache or body aches: Strep throat often causes a person to feel sick. The sickness may include body aches or headaches accompanied by any of the other symptoms mentioned in this article. 

Risks and Precautions

Strep throat is highly contagious, and spreads through air particles and droplets. To minimize the risk of getting strep, it is best to take precautions similar to those used to protect yourself against common cold or flu.

This means washing hands frequently, covering your mouth when you sneeze or cough, and not sharing food or drinks. 

If left untreated, strep throat can spread or impair your immune system.

This may result in ear, sinus, or spinal cord infections. Also, a compromised immune system caused by untreated strep throat can cause severe health complications such as kidney problems, rheumatic fever, or pediatric autoimmune neuropsychiatric disorder.

While less common, these health conditions can be quite severe. 

Who’s at Increased Risk of Having Strep Throat?

Anyone can be infected with strep throat. However, young children between ages 5 and 15 are most likely to be infected, according to the Centers for Disease Control (CDC).

Adults who work with children in a school, or those with school-aged children in their family, may also be at an increased risk. Close contact or exposure to someone diagnosed with strep throat may result in an infection.

Is Strep Throat Contagious if You Don’t Have a Fever?

If you have strep throat, you can infect someone else whether you have a fever symptom or not.

Streptococcus pyogenes, the bacteria that causes strep throat is highly contagious and can be transmitted regardless of symptoms. Strep spreads quickly, but the good news is after 24 hours on antibiotics, an infected person is no longer considered contagious. 

Treatments

Your doctor will do a rapid antigen test (a rapid strep test) using a sample of your throat culture taken with a cotton swab to determine if your sore throat is a result of strep.

The test only takes  10-20 minutes to result. If the test result shows you have strep throat, your doctor will commence a treatment plan for you.

The most common treatment for strep throat involves a round of oral antibiotic treatment. Your doctor may prescribe penicillin or amoxicillin.

Within 24 to 48 hours, symptoms should begin to subside. Keep in mind that in many cases sore throats are due to viral illnesses and do not require antibiotics. 

However, if there is no improvement after 48 hours, it would be best to contact your doctor. 

Studies show that alternative medications like Cephalexin or an intramuscular dose of benzathine penicillin G are options for those unable to tolerate oral antibiotics (e.g., a very sick child) or are allergic to commonly prescribed varieties.

You can take over-the-counter pain relievers, like ibuprofen or acetaminophen to help with symptoms while you wait for test results. Pain relievers help relieve pain symptoms.

It is also a good idea to get lots of rest and drink warm liquids, like tea and broth, when you are recovering.

What Else Could it Be?

Even if you experience symptoms similar to strep throat, the causes of your sore throat may not be a strep infection or even bacterial. Different diseases share similar symptoms.  

How to Determine if it is Strep

If you think you have strep throat, the best way to get answers fast is to visit your doctor. They will perform a physical exam and test for strep throat. 

Other Possibilities

Strep throat symptoms can mimic viral infections such as common cold and flu. A runny nose and cough are more likely signs of a viral infection than a bacterial infection.

Other viral infections that may present with similar symptoms as strep throat include mono (mononucleosis), measles, chicken pox, and croup. 

Also, the sore throat and soreness you experience when swallowing may not be a result of strep throat. Rather, they may be caused by allergies, irritants in your environment like second-hand smoke and chemicals, GERD, and vocal muscle strain. 

Concerned you have strep throat? Chat with a doctor with K Health.
get started

When to See a Doctor

If you do not treat strep throat, the infection may cause you serious health problems. 

So if you notice symptoms such as those listed above, it is best to see a healthcare professional as soon as possible. Also, if you have been in contact with someone diagnosed with strep ensure you get tested.

If you receive a positive strep test and don’t see symptoms beginning to resolve after 48 hours of starting the antibiotic treatment, seek medical attention.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Andrew Yocum, MD

Dr Andrew Yocum is a board certified emergency physician. He graduated Summa Cum Laude from Kent State University with a Bachelor of Science in Molecular Biology before attending Northeast Ohio Medical University where he would earn his Medical Doctorate (MD).