Strep/ear Infection Without a Fever?

Updated on September 02, 2010
M.W. asks from Nampa, ID
11 answers

A few times my kids have been diagnosed with bad ear infections or strep, and one time walking pneumonia. All of these kids have had either no fever or low grade fevers. I always have figured that a higher fever for a 3 or more days means they need to see the doctor. My fear is that they have something serious that needs antibiotics, and I will miss it and they will be sick or a longer time and get complications, like how my daughter had walking pneumonia and I had no idea. Why do they not get fevers? So then I started taking them to the doctor when they had bad colds. I did that twice and they just had colds. Are there some other key symptoms that I am missing?
Right now my daughter threw up like one tablespoon today, one tablespoon yesterday, and her throat hurts. She has a low grade fever of 99.8. Normally, I would do nothing but keep her home from school and make her rest and drink a lot. I can't take her to the doctor for every little thing. What should I do?

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So What Happened?

Thank you all you moms. I took my daughter to the doc and she just had a mild virus and no strep. But at least I have no worries.

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answers from Dallas on

My daughter NEVER gets a fever with her ear infections and it is almost frustrating because the only way for me to tell that something is wrong is her constant crankyness which isn't like her at all. So, I try to keep an eye on her but I always call the doc if I think something is up.

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answers from Tampa on

It is possible to not have fevers with both ear infections and pneumonia. It's tough with kids, since they aren't very good communicators, but I know when I had pneumonia, I just felt really, really tired and sick, and I couldn't seem to shake it. But since I had no fever, I wasn't too concerned. The doctor finally convinced me to get a chest xray, and lo and behold, pneumonia. So no, I don't think you're missing anything. If your kids have a cold that doesn't seem to be getting better after a week, and/or is getting worse, or if they just act really sick, I would have it checked out. Yes, you may have some unnecessary doctor's visits, but it's better to err on the side of caution if you're at all unsure.

You could also just call a nurse advice line, and they will talk you through the appropriate questions and help you decide whether further action is needed. I am not familiar with your area, but we have one here that is affiliated with a children's hospital, and they are available 24/7 to call and ask questions.

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answers from Houston on

With strep, my kids get headaches, no fever, and their throats burn.
My girls never got ear infections. My son though had 9 inner ear infections in 6 months. He never got a fever with one of them. He claws his ears, hardly sleeps, and gets cranky.

You just have to learn their cues. Fever is just the way some bodies fight the infections they have. In fact, you can have a really high fever with no need for antibiotics.

Good luck! :)

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answers from Portland on

Hi M.

Have you ever taken your child's tempature when they are well? I normally run at least 1 to 1.5 degrees cooler than 98.6, so when I'm at 99.9, I'd have a fever. Your children MAY have a fever based on their normal body tempature.

Secondly, while this sounds silly, did you give your child motrin to ease the pain and forget about it? It is so easy to think of advil etc as a pain reliever, but it also eases fevers. OR, did you let her drink some cool drinks to sooth the throat before taking her tempature? These little things can effect the tempature.

When I was a kid, I had strep for 2 weeks before my Mom took me to the doc, because I didn't have any "normal" symptoms. It's a good idea to learn your child's illness cues, like being tired or clingy. Our bodies react differently to illness, your daughter may not get fevers etc.

I hope this helps.

R. Magby

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answers from Portland on

A fever is only one symptom. Look up various illnesses so that you know the other symptoms. For example: the throat is very red with a strep infection. And the throat hurts too bad to swallow. My granddaughter also gets very lethargic. The only way to know for sure if it's strep is with a culture. The school nurse knew it was strep and the culture taken at the doctor's office confirmed it. I suggest that with experience you will begin to recognize symptoms.

Ear infections usually are recognizable when the child pulls at his ear and if old enough to complain, complains of pain.

I suggest that keeping your child home and wait to see if (s)he improves is a reasonable thing to do. The medical community is finding that it's best to use anti-biotics as seldom as possible. If your child is improving after a few days they didn't need the anti-biotics in the first place.

With a school age child, my first thought is always what is going around at school. Most likely she has what other children have already had or are having now. You can call the school and ask what is going around illness wise.

Vomiting a tablespoon of fluid is no reason to be concerned. A sore throat is also typical of common viruses. You're doing the right thing. I know it's hard to wait and see but if you took her to the doctor he would tell you that.

A serious illness will manifest its self with serious symptoms that you can't miss. One of those is a high fever, even with your children. A strep throat and an ear infection are not serious unless the child stays obviously ill for over a week. I've had strep throats that I didn't go in for a diagnosis for until the second week of soreness because I could still swallow fluids. It's dehydration that is the main concern.

It's chronic ear infections with a high fever that cause concern.

I suggest that your children are normal and the degree of fever does indicate how ill they are. They will not be harmed by your waiting to see if they get better. If they continue to get worse, that is the time to call the doctor's office and ask about it. They will have you come in if they think it's helpful.

I've had colds and sore throats that have lingered for weeks. Most of my friends have had the same experience. We finally go in and are told, "it's a virus. "There is nothing I can do for you. Continue to drink plenty of fluids, get rest, take ibuprofen or Tylenol for the aches and come back if you're not better in a couple of weeks." I have gone back and been once again told the same thing. The only time the visit was different is when I had mild congestion in my chest and he diagnosed walking pneumonia. I think I took an anti-biotic for it. Usually, I've been told that the anti-biotic is to prevent me from getting a secondary bacterial infection. I think my pneumonia was still considered to be a virus.

Continue as you are doing. Keep them home, resting, and drinking plenty of fluids. The pediatricians I've had experience with have all said that they are usually not concerned when a fever is less than 102 or so when the child is school age and only has cold or flu symptoms or it lasts longer than a few days. Always call, tho, if you're concerned.

My daughter and now my grandchildren were rarely ill longer than a week. They were usually well enough to go to school by Friday and then I was faced with the decision of whether or not to send them, which is another post. :)



answers from New York on

My kids get only low fevers (around 99 to 100) with an ear infection but no fever with just a cold. But my son actually burst his eardrum the first time he had a ear infection because he had a fever but almost no congestion. Sometimes it is hard to tell.


answers from Dover on

My daughter doesn't tend to run a fever either. We've been there before for a well visit, no fever, no complaints, no symptoms and the doctor has discovered an ear infection! Sometimes you just have to go w/ your gut.



answers from Boise on

If they always run low when they run a fever, it is possible they run a low body temp at other times. Take thier temps while they are well and see.


answers from Chicago on

My oldest doesn't run a fever with strep either. The last time she had strep, her throat wasn't all that sore, but she was lethargic and had some swollen glands in her neck. The doc ran a strep test just as a precaution and expected it to be negative. We were all suprised that it was positive!

If I were you, I'd take her to the doc just to be sure. Strep is nothing to mess around with. If untreated, it can develop into rheumatic fever, which can damage the heart.

Hope your daughter feels better soon!



answers from Boston on

What does her throat look like? An upset stomach is common w/ strep in kids and my son is like that too but his temp seems to run lower in general around 97 is normal for him. The only time it went high was last fall when he had h1n1 and then this summer when he had lyme and these were also the only times he acted sick.



answers from Columbus on

Some times they just don't run a fever. The upset stomach is sometimes part of strep, and looking at the throat is sometimes going to tell you to go to the Dr, but I can't tell when my husband can. I am always so grateful when our school sends home a note that someone in the class had strep recently, so that I am less likely to ignore what may seem to be mild symptoms and take my child in for a swab. I would return the favor so that it stops spreading (this time!) and call the nurse at your school anytime you have a positve strep test.

Some key things are (sorry, ewww) green snot, a productive green cough, or a cough that goes on way too long with fatigue. For ears, some kids have more pain when they lay down, but you just have to depend on them to tell you how they feel, I have one child that never had a fever with ears, very frustrating to figure out when to go to the doctor.

It just goes with the territory!

I hope she feels better soon.


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