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Suggest Treatment For Recurring Streptococcal Infections
Question: for this past year I have had "strep" 6 times already. here in the army you never know who you'll get as a dr. well after going 3 days in a row today they told me it's never been strep. all the cultures I've had were negative. and last month they did a blood test and found high white blood cells and platelets. so they don't think it's viral or bacterial now. they put in a referral for an ENT but I don't think I can wait it out for 2 more months. what could this possibly be? it's all they symptoms of strep including white patches, it comes on every two to three weeks. each time getting worse and worse. this time I have a tension headache that makes me dizzy and a little slow.
Brief Answer:
probably infectious
Detailed Answer:
Hello,
it's not unusual for someone coming into contact with so many people to experience frequent upper respiratory tract infections, like the ones you've described. Some individuals are more prone to pharyngitis than others.
Since all attacks ended with complete resolution of the symptoms and they recurred later, it's likely that it was of infectious etiology. There are many potential infectious causes. Streptococcus (group A) is only one of them. Numerous viruses and bacteria may be implicated in pharyngitis.
A negative culture excludes streptococcal involvement with an almost 100% certainty. Another commonly implicated pathogen, which also causes white blood cells count disorders is the Epstein-Barr virus (it causes infectious mononucleosis). Other causes like HIV will have to be investigated as well.
Useful tests would include a throat culture and C-Reactive protein measurement (CRP). CRP is a useful indicator of inflammation. High CRP measurements are usually caused by bacteria. Lower elevations can be caused by viruses.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
probably infectious
Detailed Answer:
Hello,
it's not unusual for someone coming into contact with so many people to experience frequent upper respiratory tract infections, like the ones you've described. Some individuals are more prone to pharyngitis than others.
Since all attacks ended with complete resolution of the symptoms and they recurred later, it's likely that it was of infectious etiology. There are many potential infectious causes. Streptococcus (group A) is only one of them. Numerous viruses and bacteria may be implicated in pharyngitis.
A negative culture excludes streptococcal involvement with an almost 100% certainty. Another commonly implicated pathogen, which also causes white blood cells count disorders is the Epstein-Barr virus (it causes infectious mononucleosis). Other causes like HIV will have to be investigated as well.
Useful tests would include a throat culture and C-Reactive protein measurement (CRP). CRP is a useful indicator of inflammation. High CRP measurements are usually caused by bacteria. Lower elevations can be caused by viruses.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I'm sorry I forgot to put that throat cultures came up with nothing, they did one about 3 weeks ago and was negative for mono and pretty much everything but every time they give me penicillin I'm better within the 24hrs, my dr said that's just in my head because viruses can't be treated, is this true?
Brief Answer:
viruses can't be treated...
Detailed Answer:
It's true that viruses can't be treated. And there is another interesting point: treatment for most bacteria only limits the duration of the illness by 1-2 days. Of course it does much more than that (prevents complications). Since the cultures and mono were negative, there is no clue about the pathogen.
Using any antibiotic twice within a 3-4 month time is not the best practice. For a case like yours I would have asked for tests like the ones I've mentioned (CRP mostly) which may grossly discriminate between viruses and bacteria. Other useful clinical information that may help include:
- the presence of cough or runny nose is against bacterial disease
- enlarged lymph nodes are usually caused by bacteria, although viral diseases may also cause them (HIV, Epstein-Barr, etc).
Kind Regards!
viruses can't be treated...
Detailed Answer:
It's true that viruses can't be treated. And there is another interesting point: treatment for most bacteria only limits the duration of the illness by 1-2 days. Of course it does much more than that (prevents complications). Since the cultures and mono were negative, there is no clue about the pathogen.
Using any antibiotic twice within a 3-4 month time is not the best practice. For a case like yours I would have asked for tests like the ones I've mentioned (CRP mostly) which may grossly discriminate between viruses and bacteria. Other useful clinical information that may help include:
- the presence of cough or runny nose is against bacterial disease
- enlarged lymph nodes are usually caused by bacteria, although viral diseases may also cause them (HIV, Epstein-Barr, etc).
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much for your answers they were really helpful, now I just wish I could convince the army to do some actual tests instead of brushing me off. I've also had antibiotics 6 times in 3 months, including a penicillin shot while on penicillin in pill form. is that safe? also my last question would be are there any signs I should look for regarding going to the emergency room? it's getting hard to even swallow water and my tonsils touch on either side. (I've also gotten what they said was a platelet rash each time I've been sick)
Brief Answer:
it's relatetively safe...
Detailed Answer:
You're welcome!
Let me start from penicillin treatment. Unless you exceed 30 million units there is no safety concern besides the common side effects like allergic reactions, diarrhea, etc. There is no way to exceed 30 millions units for pharyngitis, so don't worry about the dosage.
Serious signs include breathing difficulty (shortness of breath) caused by excessively enlarged tonsils, abscess (uneven tonsil enlargement) and any kind of complication like low blood pressure and faintness or new symptoms besides the aforementioned ones.
it's relatetively safe...
Detailed Answer:
You're welcome!
Let me start from penicillin treatment. Unless you exceed 30 million units there is no safety concern besides the common side effects like allergic reactions, diarrhea, etc. There is no way to exceed 30 millions units for pharyngitis, so don't worry about the dosage.
Serious signs include breathing difficulty (shortness of breath) caused by excessively enlarged tonsils, abscess (uneven tonsil enlargement) and any kind of complication like low blood pressure and faintness or new symptoms besides the aforementioned ones.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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