Why Do I Have a Sore Throat but No Fever? (2024)

Sore throats can cause significant pain, especially when swallowing. There are several reasons why you might develop a sore throat. However, viruses are the most common culprit for them. Depending on how your body responds to an illness, a sore throat may be your only symptom. Or you may develop a sore throat first before you develop other symptoms.

Sometimes, bacteria cause sore throats, such as the bacteria that causes strep throat. There are also other non-infectious reasons you might experience a sore throat with no other symptoms. Examples include a dry environment or allergies.

Strep Throat

When someone has a sore throat, they may be concerned that they have strep throat. However, only about 10% of sore throats in adults and 30% in kids are caused by strep throat. Additionally, most cases of strep throat involve other symptoms, such as a fever. So, if you have a sore throat with no other symptoms, it is less likely to be strep throat.

Strep throat is caused by the bacteria group AStreptococcus. Common symptoms include:

• Sore throat
• Fever
• Swollen lymph nodes in the neck
• Redness inside the throat
• Visible pus or white patches on the tonsils

A diagnosis of strep throat is done with a throat swab to test for the bacteria that causes it. If your healthcare provider diagnoses you with strep throat, they will prescribe antibiotics to clear the infection.

Viruses

Viruses are the main cause of sore throats, with about 50%–80% of sore throat cases in adults resulting from viruses such as:

• Rhinovirus
• Influenza
• Adenovirus
• Coronavirus
• Parainfluenza
• Herpes
  
• Epstein-Barr
• Human immunodeficiency virus (HIV)
• Coxsackievirus

Viral illnesses that cause a sore throat can also cause other cold-like symptoms, including fever, stuffy nose, and cough. However, it is possible to have a viral infection with a sore throat as the main symptom. There are few cures or treatments for viral infections outside of supportive care, and symptoms will usually pass within two to three weeks.

Rhinoviruses are the top viral cause of common colds, but several other viruses can also cause colds, too.

Bacterial Infections

A sore throat can also be caused by a bacterial infection. These infections often also cause a fever, but that's not always the case.While group A Streptococcus, or group A strep, is a common culprit in bacterial infections that cause sore throat, there are several other bacterial causes of sore throats.

Bacteria other than group A strep that can cause sore throats include:

• Group B strep
• Group C strep
• Chlamydia pneumoniae
• Mycoplasma pneumoniae
• Haemophilus influenzae
• Candida
• Neisseria meningitidis
• Neisseria gonorrhoeae
• Arcanobacterium haemolyticum
• Fusobacterium necrophorum
• Corynebacterium diphtheriae

Bacterial infections can also lead to other complications that can cause a sore throat, including abscesses, ulcers, or infections of the lymph nodes. Antibiotics alongside supportive care can usually treat and often cure these infections for symptom relief.

Tonsillitis

Tonsillitis is a condition that develops from swelling in the tonsils, which are lumps of tissue located in the back of your throat. It can be difficult to determine whether this pain is centered in the throat or the tonsils themselves because the entire area often becomes irritated and inflamed.

The tonsils are part of your lymphatic system, which helps to clear waste and infections from your body. Tonsillitis is most common in children and can be caused by bacteria or viruses.

A fever may or may not appear with tonsillitis. The condition is often diagnosed after a person experiences a sore throat and other symptoms such as:

• Red or swollen tonsils
• Difficulty or pain with swallowing
• A white or yellow coating on the tonsils
• Swollen glands/lymph nodes in the neck
• Bad breath

Tonsillitis caused by a virus will pass in time with no treatment, but bacterial causes typically require antibiotics. Repeated cases of tonsillitis are sometimes treated with a tonsillectomy—the surgical removal of the tonsils.

Allergies

Allergies can also cause you to develop a sore throat. Seasonal allergies to things like pollens can irritate the nose and throat, causing drainage and irritation.

There are no cures for sore throats caused by allergies. Instead, the strategy is usually to get your allergic response under control to prevent symptoms, such as a runny nose or sore throat. This might include using treatments like antihistamines and other allergy medications.

Acid Reflux

You can also experience a sore throat if you have gastroesophageal reflux disease (GERD). In severe or chronic cases of GERD, the acids in your stomach can rise into your esophagus and irritate the lining of your throat. If this problem goes on for too long, it can even cause permanent changes to the tissue in your esophagus (Barrett's esophagus).

Your healthcare provider may recommend diet changes, weight loss, and medications to help control stomach acid production and reflux.

Sexually Transmitted Infections (STIs)

A sore throat may not be the first symptom that comes to mind when you think of a sexually transmitted infection, but any type of sexually transmitted bacterium or virus can colonize the mouth and throat, too.

These infections usually spread through oral sex and may initially develop with no symptoms at all. A sore throat can sometimes be a symptom of an oral STI. Using oral protection like dental dams during oral sex can help prevent the transmission of STIs.

Environmental Irritants

Apart from allergens, there are also other things you can inhale that can irritate your throat and cause soreness or inflammation. These include things like air pollution, smoke, and other chemicals. If you are using harsh chemicals that you might breathe in, wear a mask. Supportive care and avoidance of irritants are the best ways to manage these types of sore throats.

If you live in an area prone to wildfire smoke or other air pollutants, consider running an air purifier and keeping windows closed, if possible, on days with poor air quality.

Cancers

About 31,000 people in the United States (most of them over the age of 55) receive a throat cancer diagnosis each year—mostly in people over the age of 55. A sore throat that won't go away is just one of the symptoms you may notice with throat cancer. Other symptoms can include:

• Swallowing problems
• Ear pain
• Voice changes
• Nosebleeds
• Headache
• Weight loss
• Bad breath
• Stiff jaw

Throat cancers are most common in people who:

• Use any kind of tobacco products
• Drink excessive amounts of alcohol
• Are infected with the human papillomavirus (HPV)
• Have poor oral hygiene
• Are infected with the Epstein-Barr virus
• Are deficient in certain vitamins or have a poor diet

Throat cancer is an uncommon reason for a sore throat. If you have a persistent sore throat and are concerned you might have throat cancer, reach out to a medical provider for advice.

When to See a Healthcare Provider

If you experience a sore throat that won't go away or you have other symptoms, such as a fever or other signs of infection, contact your healthcare provider.

Emergency care might be necessary if you develop symptoms such as:

• Throat swelling
• Difficulty breathing
• Vomiting or coughing up blood

If you experience these symptoms, call 911 or go directly to the emergency department.

Summary

Many things can cause a sore throat, such as viral or bacterial infections. However, in some instances, a sore throat may be the main or only symptom.

There are other causes of a sore throat that are less likely to present with other symptoms, such as fever. These causes include allergies, acid reflux, colds, STIs, environmental pollutants, or, rarely, cancer.

The treatment of your sore throat depends on the cause. If your sore throat is severe, presents with signs of an infection such as a fever, or lasts for several weeks without improvement, make an appointment with your healthcare provider for an evaluation.