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What Causes Persistent Sore Throat With Negative Strep Tests?

Posted on Fri, 13 Mar 2015

Question: My daughter (16) has had a sore throat for 3 weeks that has been worsening. She has had 2 strep tests and 1 mono test, the rapid report states that they are both negative, we are awaiting the final results. She had mono when she was 8 years old, I personally do not think that she has this. Her tonsils are very large however the Dr's do not see anything there. When I listen to her it is evident that her throat hurts, she sounds like she has swallowed an orange. Her breath smells of infection, (no periodontal disease or gingivitis). She breathes from her mouth now and she sounds as if she has a deep sinus thing going on.

Answered by Dr. Tushar Kanti Biswas (34 minutes later)

Brief Answer:
Throat infection

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Rapid strep tests sometimes may miss streptococcal throat infection. As her symptoms are persistent, I will advice throat swab culture which remains the golden test. Pending culture report you need to start a first line antibiotic e.g. azithromycin (standard adult dose 500 mg orally daily for a period of 3-5 days) or Linezolid empirically.

Monospot test is done to check for antibodies to the Epstein-Barr virus. The currrent symptoms may or may not be related.

You need to discuss with your doctor.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

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Above answer was peer-reviewed by : Dr. Prasad