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Symptoms of a Streptococcal infection - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2009
Answered : 675 Questions
User :   In May 2009, I had sex with a British lady I met in Europe, the sex was protected. The first session we had lasted about 5 minutes before I ejaculated, when I went to go remove the condom, I noticed a bit of red in the inside tip, the condom looked intact. We had another protected session which lasted longer.
After about 9 / 10 days, I had a headache then the next day my jaws were sore. The day after that, I felt a sharp pain in my throat, I couldn't swallow the following day so I went to hospital, they did a test and said there was no bacterial infection so they prescribed me some anti-inflammatories & pain-killers. After 3 days, I couldn't take the pain anymore so I went back to the hospital and I think by then, the throat culture they had taken before had 'matured' so they said I had strep and they prescribed me some antibiotics. I felt no pain after taking about 2 antibiotics, halfway during the 10 day antibiotic course, I started having pain in my neck glands and later on in my armpits as well as throughout the arms. I also had a lot of pain in my wrists and elbows. My tonsils were red and swollen, especially the left one but is not painful, just the feeling of having something stuck in the throat.
I also started to experience pain in my sides, like liver / spleen area, it wasn't too sharp though. Over the Christmas holiday, I was in a warmer country, felt a lot better. When I got back to the sub-zero European temperatures, I started having a bit of pain in my elbows and my sides.
I have been to scared to go for an HIV test I did however go to see the doctor to test for things like EBV, CMV, etc. The results came out ok, but showed a likelihood of a previous CMV infection, not sure if that was due to immunisation but the doc just said to me I was fine. The pain has subsided but I still feel it a bit in my sides & arms, I had a tonsillectomy recently. What is
User :   wrong with me? I cannot even sit properly at my desk.
User :   hi doctor
Doctor :   Hi,
User :   thanks, please help me, i have a lovely daughter & wife, everyday i worry, i don't know what's happening with me
Doctor :   Let me read your query for few minutes to be able to have a good discussion here.
User :   ok
Doctor :   What test for CMV have you got done ?
User :   it's the IGG & the other 1 IG something, i haven't got them here, i'm away on business so left the results in my locker at work
Doctor :   the symptoms are overlapping
User :   u mean it's not 1 thing?
Doctor :   both strep and CMV can produce such symptoms
Doctor :   no , it could be either
Doctor :   both do spread by body fluids , kissing , smooch etc
User :   it's been 18 months now, as i type, my wrists r sore, i've had ultra-sound done as well, my insides were deemed to be fine
Doctor :   hence i advice you to get a test called CMV PCR
User :   how different is it from the IGG?
Doctor :   These are constitutional symptoms , they jus need to be managed symptomatically , with antiinflammatories
User :   i meant the difference between the PCR & IGG tests?
Doctor :   IGG counts your antibody response to the virus where as the CMV PCR will directly detect the Virus
Doctor :   once you rule out CMV by PCR test then it can be confirmed that it is due to strep
Doctor :   then you may be need to be put on higher antibiotics
User :   the experts there were saying that if my condom had failed, it would have done so fatally and that if i'd had contacted it, ARS would not have lasted this long, what do u think?
User :   so how do i approach my doctor then, i ask him to do the PCR and also test bacteria?
Doctor :   yes, the possibilities of HIV are remote
Doctor :   as the symptoms due to HIV go unnoticed
User :   i'm so scared doc, please let me know what i shud do when i get back home
Doctor :   and yes you have to visit your GP ask for the PCR test rule out CMV get a repeat culture of the throat
User :   the throat is giving no problems, i had the tonsillectomy done in april so i have no problems there
Doctor :   some resistant species of Strep do stay for months in body and lead to a chronic illness hence you may have to be put on higher antibiotic if PCR negative and culture positive
User :   my wrist, elbows and torso sides are the main issues
User :   so i shud get tested for strep?
Doctor :   ok, if tonsillectomy done then you cant go for throat culture
Doctor :   you can straight away be put on antibiotic course
User :   on the basis of...?
Doctor :   tonsills are the place where the bacteria reside
User :   they don't give antibiotics easily here
Doctor :   antibiotics on the basis of previous diagnosis of strep
User :   even if it was 18 months ago?
Doctor :   it will be empirical antibiotic treatment i mean cover treatment
User :   won't they need to do bloods again & if they find nothing, then they don't prescribe them
Doctor :   yes, some doctors may go for blood tests to be evidence based
Doctor :   for sure if strep induced your blood tests will show signs
User :   my work performance has dropped drastically, i play hide & seek with my bosses, they don't know that i'm in pain
Doctor :   follow my advice , stepwise
User :   so what blood tests do i need to do in order to check for strep? last time he checked for some toxins, etc, i ca't really remember & he said i was fine
Doctor :   you will get assured
User :   ok, please let me know what tests i should ask for the bacteria / strep?
Doctor :   completel blood count
User :   sorry again, i've had that done, there was nothing amiss apparently
User :   except for that CMV that i spotted
Doctor :   when was it done ?
User :   it was done in april as well
Doctor :   well it is old , by this time there could be more change in the blood if its due to strep...
Doctor :   the blood counts do show change even in days
User :   in your experience, what do u think i have?
Doctor :   i still doubt CMV strongly
User :   so u suspect what?
Doctor :   Infectious mononucleosis by CMV
User :   ok, so that one has no diagnosis i suppose?
User :   ?
Doctor :   the diagnosis is infectious mono
Doctor :   threre is treatment also
User :   so they test it via the PCR?
Doctor :   antiviral
Doctor :   yes
User :   ok, i'll try that then, it just breaks my heart what i'm going thru
Doctor :   do not worry . just follow the sequence
User :   there's nothing that i can buy over the counter for now? i still have 4 more days out here, i'm in denmark, i live in france
Doctor :   you can have pain killers which were advised in past
User :   ok thanks for ur help
Doctor :   Thanks for consulting me
Doctor :   Bye for now
Doctor :   Take care

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