Tonsillitis Without Fever: Does It Happen and How Does It Manifest?

Sore throat is usually associated with a high temperature. But inflammation of the tonsils does not always cause fever, and this can be confusing. Let's look at how to recognize tonsillitis when the thermometer stays normal.

Can there be tonsillitis without fever

Acute tonsillitis is an infectious inflammation of the lymphoid pharyngeal ring, most often of the palatine tonsils. It is most commonly caused by bacteria (streptococci, staphylococci), less often by viruses and fungi. Fever is a common but not obligatory sign. In the catarrhal form, the temperature is usually subfebrile, that is, it stays low. This means that tonsillitis without a noticeable rise in temperature is possible.

Why the temperature may not rise

The tonsils are a kind of acoustic filter of the throat: they catch what enters through the mouth and nose. Tonsillitis can be caused by both viruses and bacteria. In catarrhal tonsillitis, changes in the blood are minor, and the temperature remains subfebrile.

Symptoms of tonsillitis without fever

The picture consists of local signs. A person complains of pain when swallowing, dryness, tickling, burning in the throat. The tonsils are red and swollen, there may be a white or yellow coating on them, and breath from the mouth is unpleasant. Enlarged lymph nodes may be felt on the neck, and a mild cough is possible.

• sore throat that worsens when swallowing;
• dryness, tickling and burning;
• red, swollen tonsils with coating;
• enlarged lymph nodes on the neck;
• bad breath.

Purulent and bacterial tonsillitis without fever

The bacterial nature is most often associated with group A beta-hemolytic streptococcus: it causes more than half of tonsillitis cases. The appearance of a white or yellow coating on the tonsils is a reason for a doctor's examination: it is bacterial tonsillitis that needs assessment and, if confirmed, treatment.

Tonsillitis without fever in adults and in a child

In adults, tonsillitis occurs, but not very often. In children, it is common: almost every child has it at least once, more often after the age of two. Bacterial tonsillitis is more typical for children aged 5–15 years, viral tonsillitis for younger children. In children, local symptoms may be accompanied by a high temperature and lethargy, but the absence of fever does not rule out the disease.

How tonsillitis is diagnosed and when a doctor is needed

The doctor asks about symptoms and medical history, examines the throat and neck, and looks for redness, coating and enlarged lymph nodes. To test for streptococcus, a swab is taken with a cotton swab from the tonsils and the back of the throat: a rapid test is performed in the office and the result is ready in minutes; a culture is done in the laboratory and takes several days. Culture is considered more reliable, so if the rapid test is negative, a culture is sometimes additionally performed. You should see a doctor if the sore throat does not go away within a week, recurs often, or is accompanied by a mouth ulcer for more than three weeks.

Tonsillitis without fever is not in itself a reason to call an ambulance. Call 103 or 112 if it is difficult to breathe or swallow, saliva flows, a whistling sound is heard on inhalation, or the condition quickly worsens.

This material is for reference: it explains the picture of the disease but does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer