OpenHealth Q&A

34-Year-Old Male with Throat Infection - Seeking Advice After Negative Strep Test

Hello everyone, I’m reaching out for advice about a health issue I'm facing. I live in the UK and am currently utilizing the NHS, where my testing and treatment options are quite restricted. I’m a 34-year-old male, Caucasian, standing at 179 cm tall and weighing 86 kg. I don't smoke and have a compromised immune system, leading to more frequent illnesses than average. Additionally, I have been diagnosed with Long Covid, which includes symptoms like fatigue, brain fog, and post-exertional malaise. A week ago, I began experiencing severe pain in my throat that made eating and swallowing extremely uncomfortable. Accompanying this were symptoms of intense fatigue, excessive sweating, chills that made me feel freezing, and headaches, though I did not have a fever. Given that I tend to get throat infections fairly regularly, I delayed seeking medical help, as they typically resolve within a day or two. However, this particular episode only worsened over three days. On the third day, I used my phone to examine my throat and observed concerning signs. I visited my general practitioner (GP), who conducted a strep test via throat swab and prescribed a 5-day course of penicillin antibiotics. Although the antibiotics started showing some effect after a delay, I can see gradual improvement now. As of today, I'm on day 6 of the infection. My lymph nodes remain swollen but have reduced in size compared to a few days ago. Unfortunately, the strep test results returned negative, but my doctor indicated that it could still be caused by a different bacterial infection. I expressed concerns over running out of medication, as my current prescription will last until tonight, but my GP informed me that they only issue a short 5-day supply. I worry that if I have another bacterial infection, it may develop antibiotic resistance and worsen. The doctor mentioned the possibility of a viral infection but was unwilling to conduct tests for Epstein-Barr virus (EBV) or any other viruses. Despite my request for an EBV panel, he stated that such tests are typically reserved for children. Given my struggle with Long Covid, I am apprehensive about the chance of contracting another illness and feel the need to understand my current condition for effective treatment. I even inquired about antiviral medications, but the doctor declined to prescribe those. It seems that I have no choice but to wait and hope for improvement. I've also scheduled an STD test as a precaution. In light of my recent sexual encounter two months prior with a woman who reacted defensively to questions about STDs—despite providing past negative results that I suspect could be falsified—I want to determine if I might have contracted something. I've had tests done at two intervals following the contact, with negative results, but those tests did not include a throat swab, leaving some uncertainty. I plan to request a throat swab during my upcoming STD test. Since it appears that the NHS may not meet my needs adequately, I’m contemplating going private for further examinations. What should I specifically request from a doctor, and how can I locate one willing to provide an EBV panel as well as tests for other viruses?

Answers (1)

7/21/2025, 1:02:02 PM

OpenHealth AI

Thank you for sharing your concerns. It sounds like you’re managing several health issues, including a persistent throat infection and Long Covid symptoms. Here’s a summary of the key points and some steps you can take to address your situation:

Key Points:

1. Throat Infection: You're experiencing symptoms of throat pain, swollen lymph nodes, and fatigue, with a negative strep test.
2. Antibiotics: You have been prescribed a 5-day course of penicillin and are seeing some improvement.
3. Long Covid: This complicates your recovery and increases your concerns about further infections.
4. Testing Concerns: You are worried about undiagnosed viral infections, particularly EBV, and potential bacterial resistance.

Explanation:

Your throat infection could be viral or caused by bacteria not detected in the strep test. Given your history and symptoms, it’s understandable to be cautious about potential complications, especially since you have a compromised immune system.

The fact that your lymph nodes are showing gradual improvement is a positive sign. It’s also wise to be vigilant about potential exposure to additional infections, given your recent sexual encounter and ongoing health vulnerabilities.

Next Steps:

1. Complete Your Current Antibiotic Course: Finish your 5-day antibiotic course as prescribed. It's essential to allow the medication to work fully, even if you do not feel completely recovered.

2. Monitor Symptoms: Keep a close eye on your symptoms. Note any significant changes, such as worsening pain, new symptoms, or if the swelling does not continue to reduce.

3. Request Follow-up Care: Since your GP has indicated the possibility of a viral infection, consider requesting a follow-up appointment to discuss your lingering symptoms. You may ask:

   • For a throat swab to rule out other infections.
   • About getting tested for EBV and other viruses if your symptoms do not improve or worsen.

4. Consider Private Testing: If you feel that the NHS options are limited, you can seek a private healthcare provider who specializes in infectious diseases or virology. When contacting a private clinic, specifically request:

   • An EBV panel and other relevant viral tests.
   • A throat swab to check for potential bacterial infections that may not have been captured in the initial test.

5. Seek Additional Support: While managing your Long Covid symptoms, prioritize rest and hydration. Engage in gentle activities, like walking, to support your recovery, but be mindful of your energy levels.

6. Follow Up on STD Testing: Ensure that you get the throat swab included in your STD testing to address any concerns you have about potential infections from your recent encounter.

Final Thoughts:

It's entirely reasonable to seek clarity about your health, especially under these circumstances. Take one step at a time, prioritize monitoring your symptoms, and advocate for yourself during medical consultations to ensure you receive appropriate care. If you have any further questions, feel free to ask.