Usually, on the first day of illness, thermometry indicators rise sharply to 38-39 C, and remain at this level for 3-5 days. But is there a sore throat without fever? It turns out that this is really possible, but angina without fever is caused not by streptococcus, but by other pathogens. The symptoms and treatment of such a sore throat will be somewhat different, since its pathogenesis is not based on streptococcal infection, but, for example, fungal or viral.
Let's talk about how to determine the cause of inflammation of the tonsils, which proceeds without an increase in body temperature, and also discuss the treatment of angina without fever.
Is there a sore throat without fever?
The terms "tonsillitis" and "sore throat" are often used synonymously to denote a disease associated with inflammation of the tonsils. However, in the narrow sense of the word, angina is an acute disease, which is based on a bacterial infection of the tonsils (primarily streptococcal). Thus, angina is an acute bacterial tonsillitis. Streptococcal infection of the tonsils is also often called a banal, or vulgar, sore throat.
Is there a streptococcal sore throat without fever? Definitely not. High body temperature is a classic sign of a banal sore throat, along with a sharp sore throat and the formation of a white coating on the tonsils. Streptococcal infection always causes a strong immune response and intoxication of the body, therefore, in both adults and children, on the first day of illness, the body temperature rises sharply to 38-39 C. higher values.
If there is no temperature with angina, there is only one answer - you are not faced with a banal streptococcal angina, but with some other type of tonsillitis.
What types of tonsillitis can flow without fever?
There are diseases in which inflammation of the tonsils can go away without fever. Typically, these diseases are mild to moderate. All of them have an infectious etiology, and can be caused by bacteria, fungi and viruses.
The most common variants of tonsillitis 
without temperature are:
- catarrhal sore throat - a mild form of inflammation of the tonsils, which often occurs with ARVI (acute respiratory viral infection);
- fungal infection - tonsillitis caused by microscopic fungi of the genus Candida, without fever and sore throat;
- sore throat of Simanovsky-Plaut Vincent, or ulcerative necrotizing tonsillitis - a bacterial infection affecting one of the tonsils; occurs in people with a weakened immune system;
- chronic tonsillitis is a form of bacterial (streptococcal or staphylococcal) infection of the tonsils, which is characterized by the presence of plugs in the mouths of the lacunae of the tonsils.
Sore throat without fever should be treated after its cause has been determined - the infection that caused the inflammation. Treatment of viral, bacterial and fungal infections has significant differences.
Catarrhal tonsillitis
The catarrhal form of tonsillitis usually occurs as a result of viral infections (bacterial more often cause purulent forms of the disease - lacunar and follicular). Common causative agents of the disease are ARVI viruses. The incidence rate increases in the autumn-winter period, when people are most susceptible to hypothermia.
Symptoms of catarrhal sore throat:
- sore throat - usually mild, bothersome when swallowing;
- redness of the throat;
- swelling of the tonsils;
- the formation of a transparent mucous plaque on the surface of the glands;
- on the first day of the disease - a moderate increase in body temperature (up to 37-37.5 C), then the temperature is normalized; it is worth noting that catarrhal tonsillitis can be accompanied by a high temperature - sometimes its indicators exceed 39 C.
Thermometry indicators for catarrhal tonsillitis depend on many factors - the infectious causative agent of inflammation, the patient's age, the state of his immune system.
Fungal sore throat
This type of inflammation of the tonsils is caused by fungi of the genus Candida - representatives of the opportunistic microflora of the skin and mucous membranes. It is candidal tonsillitis that often occurs against the background of normal health. Indeed, the patient's thermometry indicators remain at a normal level (rarely even reach 37C), symptoms of intoxication (fatigue, headache, nausea) are absent. Even a sore throat rarely bothers with this type of sore throat.
The symptoms of the disease are:
- the formation of a white plaque on the tonsils, which has a curdled consistency;
- bad breath;
- violation of the perception of the taste of food;
- dry mouth;
- redness of the throat.
A key symptom of a fungal infection of the tonsils is a characteristic cheesy bloom. It can be easily removed from the mucous membrane without causing damage. Plaque can be in the form of lumps or a continuous loose film.
Ulcerative necrotizing tonsillitis
Ulcerative necrotizing tonsillitis is a serious and dangerous disorder that can lead to necrosis of the soft tissues of the throat. Can angina occur against the background of fever in the case of necrotizing ulcerative tonsillitis? Maybe, however, this is very rare. In most patients, thermometry values rarely exceed 37 C, they usually correspond to the norm.
The clinical picture of this disease has the following features:
- unilateral nature of the defeat of the tonsils;
- the formation of purulent plaque covering the damaged gland;
- when trying to remove plaque, inflamed tissue covered with necrotic ulcers is exposed;
- bad breath;
- satisfactory state of health of the patient, the predominance of local symptoms over general.
Necrotizing sore throat develops in people with weakened immune systems. Fasting, constant intoxication, prolonged hypothermia, and the use of immunosuppressants can become a provocateur of the disease.
Chronic tonsillitis
Being able to proceed without temperature is a diagnostically significant feature of chronic infectious processes. Chronic inflammation of lymphadenoid tissue is often the result of improper treatment of acute tonsillitis, however, cases have been recorded when the disease develops without a previous acute form. In most cases, the infectious agent of the disease is streptococcus, but it can also be staphylococcus.
Diagnostically significant signs of chronic tonsillitis:
- enlarged glands;
- thickening of the edges of the palatine arches;
- cicatricial adhesions on the border of the tonsils and soft tissues of the palate;
- changes in the structure of the tonsils - the presence of scars, seals, etc.;
- the presence of plugs in the mouths of the lacunae (they look like a dotted plaque in the depressions of the lymphadenoid tissue);
- constant swelling of nearby lymph nodes, pain when touching them.
If you notice purulent spots on the surface of the tonsils, discomfort when swallowing, but your body temperature is normal, you may have experienced a chronic form of tonsillitis.
Chronic inflammation tends to exacerbate with hypothermia, vitamin deficiency, decreased immunity in ARVI. Episodes of acute tonsillitis can bother 5 times a year or more.
Angina without fever treatment
Treatment for tonsillitis without fever must be appropriate to the cause of the disease.The diagnosis is made by the attending physician, based on a pharyngoscopic examination of the throat, clinical data and laboratory results (if necessary).
Depending on the causative agent of the disease, treatment of tonsillitis without fever includes:
- with catarrhal form - antiviral drugs (Amiksin, Arbidol, etc.), as well as antiseptic agents for treating the throat - rinsing solutions (soda solution, salt, herbal infusions), throat sprays (Ingalipt, Oralsept, Cameton), tablets and lozenges for resorption (Strepsils, Tonsillotren, Chlorfilipt, etc.);
- with fungal - antimycotics of local and systemic action (Nystatin, levorin ointment, clotrimazole, etc.), as well as antiseptics with antibacterial and antifungal effects (Lugol's solution, Chlorhexidine, lozenges or chlorphilipt tincture);
- with ulcerative necrotizing tonsillitis, strong antiseptic preparations are used to treat the tonsils: iodine, silver nitrate, novarsenol and others; if the treatment is ineffective, they resort to antibiotic therapy;
- in chronic inflammation of the tonsils, recovery requires several courses of treatment, involving active antiseptic treatment, inhalation, as well as taking systemic antibiotics and immunomodulators.
The treatment is different for each individual case. The choice of the drug depends not only on the causative agent of the disease, but also on the age, weight of the patient, the severity of the infection, and the presence of concomitant diseases.
