I imagine that nearly every mother knows about that classic sign of strep — the white streaks inside the throat. But the answer is yes, you can have strep throat without fever or pus, or without any noticeable symptoms at all.
Strep throat is infection with the Streptococcus bacteria (group A). It is not as common as many people think. Most sore throats are caused by viruses. In children, only about one out of 10 sore throats are caused by strep. Still, it is an infection to be taken very seriously. Without treatment, there is a small risk that strep throat may lead to life-threatening conditions, such as kidney disease, meningitis or rheumatic fever.
Besides the fever, pain and pus spots on the throat, strep throat may cause the throat to look very red. Swallowing may be painful and difficult. Sometimes strep throat is accompanied by swollen lymph nodes below the ear, where the jaw comes up next to the ear. There may also be headache, stomach pain or gastric distress.
A few aspects of strep throat may differ from a viral sore throat. You might suspect strep if you have a sore throat and other strep symptoms, but you don’t have the cough or head congestion that usually go along with a cold. Also, strep sometimes comes on like gangbusters, out of the blue. But with a cold or flu, you often feel a tickle in your throat or other mild symptoms for a day or two before the virus takes hold.
Strep throat usually responds very quickly to treatment with antibiotics in the penicillin family. If the patient is allergic or sensitive to penicillin, then erythromycin will probably be given. Either drug typically clears up the infection within a few days. At one time, many doctors prescribed antibiotics on a just-to-be-sure basis for strep. Today, you can expect the doctor to run a throat culture to confirm infection with strep.