Persistent Symptoms After Negative Strep Tests?
Hello, I'm a 25-year-old assigned female at birth, living in Canada. I currently take medications including Vyvanse, Wellbutrin, testosterone, and finasteride, and I've recently undergone multiple rounds of antibiotics (details below). I've been consulting various physicians at walk-in clinics regarding my health concerns. In early July, I fell ill, experiencing what I believed to be strep throat. Significant symptoms included white patches on my tonsils, swollen lymph nodes, difficulty swallowing, a decrease in appetite, fatigue, and fever. Given my job, where I'm frequently around children, I suspect I might have contracted something there. After a week without improvement, I visited a doctor who noted all the classic signs associated with strep throat and prescribed a 10-day course of amoxicillin. Since I tend to experience yeast infections following antibiotic treatment, I was also given fluconazole for a few days afterward. After a couple of days on the amoxicillin, I began to feel better and completed the full course of medication. Additionally, I started taking a probiotic with bacillus coagulans to mitigate digestive issues, and I’ve been diligent with that. However, just three days after finishing the antibiotics, my symptoms resurfaced—white patches appeared on my tonsils, lymph nodes swelled again, swallowing became painful, my appetite diminished, and I felt fatigued. I consulted another doctor who suspected strep once more; they conducted a throat culture and prescribed 10 days of clavulin and fluconazole again. When the results came back, they indicated "No Streptococcus pyogenes (Group A) isolated." By that time, I was already well into the antibiotics and my symptoms were diminishing, so I didn't think much about it. Three days after completing the clavulin, the white patches returned, accompanied by mild discomfort when swallowing, swollen lymph nodes, lack of appetite, fatigue, and some muscle soreness. I visited a third physician who explained that, in some instances, strep bacteria can hide in areas of the tonsils that might be unreachable by antibiotics. They performed another culture and initiated treatment with azithromycin (500 mg daily for three days, without fluconazole). I've begun to feel a bit better—no difficulty swallowing, reduced fatigue, and visible improvement in my tonsils, although I've been experiencing some nausea, possibly from the azithromycin. I just received the throat culture results again, indicating "No Streptococcus pyogenes (Group A) isolated." I'm worried about what could be causing my recurring symptoms. What are the odds that it isn’t strep? If it isn’t, what else might be responsible? The last doctor I consulted expressed confidence that it was strep and mentioned that if the issue persists, they might refer me to an ENT specialist to discuss the possibility of tonsillectomy. I really want to avoid that if I can! I'm anxious about the potential for these symptoms to return after the azithromycin, and I'm growing increasingly frustrated with missing out on school and work due to illness. Any thoughts or advice would be greatly appreciated! Thank you!
Answers (1)
8/15/2025, 6:12:35 PM
OpenHealth AI
It sounds like you've been through a lot with your recurring symptoms, and it's completely understandable to feel frustrated and anxious about the situation. Your persistent symptoms could potentially stem from various causes outside of strep throat, especially since your throat cultures have consistently returned negative for Group A strep.
Explanation:
While your symptoms — such as white patches on the tonsils, swollen lymph nodes, and difficulty swallowing — are indeed common with strep throat, they can also be attributed to several other conditions. These might include:
- Viral Infections: Many viruses can cause similar throat symptoms, including infectious mononucleosis (commonly caused by Epstein-Barr virus), cytomegalovirus, and other respiratory viruses.
- Chronic Tonsillitis: Inflammation of the tonsils can persist even after antibiotic treatments.
- Other Bacterial Infections: There are other bacteria besides strep that could be causing your symptoms, such as Epstein-Barr virus or other atypical bacteria.
- Fungal Infections: Given your history with antibiotics, oral thrush (a yeast infection in the mouth) could also lead to white patches.
- Allergies or Irritants: Allergies can cause throat discomfort and similar symptoms.
Next Steps:
Here are some prioritized actions you can take to manage your symptoms and seek clarity:
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Symptom Tracking: Maintain a daily log of your symptoms, noting their severity, any triggers, and what helps or worsens them. This can provide valuable information for your healthcare providers.
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Consider Lifestyle Adjustments:
- Hydration: Drink plenty of fluids to help soothe your throat and reduce discomfort.
- Rest: Prioritize getting enough sleep and reducing stress, as both can help improve your immune health.
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Follow Up with Your Doctor: Since the recent cultures showed no strep, it's important to discuss these results with your healthcare provider. Ask about testing for other potential causes, such as a viral infection or allergies, and whether visiting an ENT specialist is warranted.
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Monitor for New Symptoms: If you experience significant new symptoms (e.g., high fever, difficulty breathing, worsening throat pain), seek medical attention promptly.
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Consider Probiotics and Anti-Nausea Medication: Continue your probiotic regimen to support your gut health post-antibiotics and discuss any nausea from azithromycin with your doctor. They may suggest an anti-nausea medication if needed.
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Explore Alternative Treatments: With your doctor’s approval, you might look into home remedies (like warm saltwater gargles for throat pain) or over-the-counter pain relief medications to help ease discomfort.
Remember, you are not alone in this, and it’s okay to seek second opinions if you continue to feel uncertain about your diagnosis and treatment options. Your well-being is a priority, and it’s important to address these symptoms holistically. Let me know if you need further clarification or support!
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