4 Reasons You Can Get Strep Without Tonsils

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You may be a stranger to strep throat after getting your tonsils removed. However, you can still get strep throat after a tonsillectomy. A tonsillectomy (surgery to remove your tonsils) decreases your chances of getting strep throat the year after the surgery. It can reduce the severity of symptoms if you become reinfected.

If you're feeling those familiar symptoms, keep reading to learn why you may still get strep throat after removing your tonsils, the symptoms to look for, and the treatment options.

Woman with hand on her throat, sitting at a counter talking to a healthcare provider on a tablet
andresr / Getty Images.

Strep Throat: Still a Possibility Without Tonsils

A healthcare provider may recommend removing your tonsils if you experience frequent strep throat infections. However, there are various reasons that you can still get strep throat without tonsils including:

  • Reason 1: The Group A Streptococcus bacterium that causes strep throat affects more than your tonsils. It can cause symptoms in your throat, in the tissue where your tonsils used to be, and at the roof of your mouth.
  • Reason 2: In some cases, Group A strep can progress and lead to complications, such as scarlet fever, rheumatic fever, and kidney disease, which affects other areas of your body.
  • Reason 3: Though having a tonsillectomy can lead to milder strep throat symptoms, it does not make you immune to streptococcal bacteria. You can still become infected and spread strep to others.
  • Reason 4: The potential benefit of having fewer strep infections only lasts for the first year after a tonsillectomy.

Recurring Strep Throat

If you have recurring strep throat at the following rates, a healthcare provider may recommend removing your tonsils:

  • Seven times in one year
  • Five times a year for two years
  • Three times a year for three years

Signs of Strep With vs. Without Tonsils

The signs of strep throat without tonsils are mostly the same as the signs with tonsils. One key difference is that people without tonsils will not experience the symptoms affecting the tonsils, and their symptoms may be milder.

The most common strep throat symptoms include:

Transmission and Contagiousness

You can pass strep throat through droplet transmission. This occurs when a person with strep talks, coughs, or sneezes and releases infected droplets into the air, and an uninfected person inhales them. You also can become infected by touching objects with infected droplets and then touching their mouth, nose, or eyes.

Strep throat is very contagious. People who do not have symptoms or who have minor symptoms may not be as infectious as people who have more severe symptoms. However, they are still contagious and can pass the bacterium on to others.


Healthcare providers typically treat strep throat with antibiotics like penicillin or amoxicillin. However, getting tested to confirm strep before starting antibiotics is important. If a virus causes your symptoms, antibiotics will be ineffective and may worsen your symptoms.

Some cases of strep throat resolve independently within three to five days, so antibiotics are not always necessary. However, they can help prevent complications and the spread and help you recover faster.

If you don't have tonsils, but you have been exposed or are feeling symptoms that could indicate strep, seek the support of a healthcare provider for testing and treatment.

Accessible Strep Treatment

If you do not have a primary care provider, consider a telehealth appointment or visit a local walk-in clinic for strep testing and treatment. Additionally, many pharmacies offer strep tests and can prescribe antibiotics on-site. These options do not require health insurance and may be more cost-effective and efficient than a primary care provider's office.

How Long to Wait Before Returning to Work/School

If you opt for antibiotic treatment for strep throat, returning to school or working 24 hours after starting the antibiotics is safe. If you have a fever, ensure you are fever-free for at least 24 hours without taking any fever-reducing medications, such as Tylenol (acetaminophen), before returning to school or work.


You can get strep throat after having your tonsils removed. Group A Streptococcus, the bacterium that causes redness, swelling, and inflammation in your tonsils, can also infect your throat, mouth, or other body parts. Though a tonsillectomy can decrease the number of strep infections you get the year after the surgery; it does not make you immune to strep. You can still become infected and spread the highly contagious bacteria to others.

If you don't have your tonsils, but feel that you may have strep throat, visit a healthcare provider, such as a pharmacist or a provider at a walk-in clinic for testing and treatment.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mitchell RB, Archer SM, Ishman SL, et al. Clinical practice guideline: tonsillectomy in children (Update)—executive summaryOtolaryngol--head neck surg. 2019;160(2):187-205. doi:10.1177/0194599818807917

  2. American Academy of Family Physicians. Tonsillectomy.

  3. Centers for Disease Control and Prevention. Strep throat.

  4. University of Pennsylvania Medicine. Strep throat (Streptococcal pharyngitis).

  5. Centers for Disease Control and Prevention. Strep throat: All you need to know.

  6. Icahn School of Medicine at Mount Sinai. Strep throat.

  7. Centers for Disease Control and Prevention. Be antibiotics aware: Smart use, best care.

  8. American Academy of Family Physicians. Strep throat.

  9. Harvard Medical School. 4 symptoms that mean your child must stay home from school or daycare.

By Ashley Olivine, Ph.D., MPH
Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.