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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Should Streptococcus A With Swollen Lymph Nodes And Fatigue Be Treated?

My daughter tested positive for strep back in August 14. Was started on zithromax. A week later she had persistent symptoms and I took her back in. The rapid strep was negative they also cultured which they are just telling me now (almost a month later) that the culture was positive for strep A. She has had another round of antibiotics since then and been on allergy medicine as they thought the swelling was a result of allergies. She also has swollen lymph nodes, fatigue and a really hoarse voice. HELP! I have an ENT appt for her in a week but feel like everyone is blowing me off!
Mon, 15 Dec 2014
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Infectious Diseases Specialist,  's  Response
Thanks for your query at HCM
Streptococcal A infection is curable. The swollen lymph nodes can be due to part of ongoing infections or allergy. You need to get ASO titre done from blood, as in some cases there is chance of Rheumatic fever or glomeruonephritis later.Get the blood culture done again if it come out to be positive use drugs based on susceptibility pattern found avoid penicillin, which is usually allergic. If it is negative you can take oral cephalosporins. But another possibility which cannot be ruled out is that it may be tubercular lymphadenitis too. If above treatment fails go in for ultrasound guided biopsy of lymph nodes and get ZN microscopy/ culture for Mycobacterial infection and also culture for routine aerobic/anaerobic infection. The correct diagnosis is the remedy for you.
Take care. I will be happy to take any further queries.
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How Should Streptococcus A With Swollen Lymph Nodes And Fatigue Be Treated?

Thanks for your query at HCM Streptococcal A infection is curable. The swollen lymph nodes can be due to part of ongoing infections or allergy. You need to get ASO titre done from blood, as in some cases there is chance of Rheumatic fever or glomeruonephritis later.Get the blood culture done again if it come out to be positive use drugs based on susceptibility pattern found avoid penicillin, which is usually allergic. If it is negative you can take oral cephalosporins. But another possibility which cannot be ruled out is that it may be tubercular lymphadenitis too. If above treatment fails go in for ultrasound guided biopsy of lymph nodes and get ZN microscopy/ culture for Mycobacterial infection and also culture for routine aerobic/anaerobic infection. The correct diagnosis is the remedy for you. Take care. I will be happy to take any further queries.