Persistent Strep Throat Concerns
Patient Profile: 67 years old, 5'5", weighing 190 lbs, generally in good health, currently on Dupixent for nasal polyps, non-smoker, with no significant chronic conditions. I am reaching out on behalf of my mother because I have concerns that her local physician may not be addressing her issue appropriately. Approximately two weeks ago, she tested positive for strep throat following common symptoms that persisted for just a few days. Due to a suspected allergy to penicillin, her doctor prescribed azithromycin. After a few days of treatment, there was no improvement, prompting a return visit where she was still found to be positive for strep, leading to a prescription for Clindamycin. However, after another few days, there was still no change in her condition. Despite repeated rapid strep tests indicating a positive result, a throat culture was conducted. She was then placed on amoxicillin, accompanied by diphenhydramine as a precautionary measure against potential allergic reactions. It turns out that the alleged allergy was unfounded; nevertheless, 48 hours have passed, and she is still feeling unwell, now accompanied by significantly swollen lymph nodes. We are still awaiting the culture results. The doctor has ordered a CT scan for tomorrow, but I am uncertain about the necessity of this step. I feel frustrated with the situation and she is resistant to going to the emergency room for further evaluation.
Answers (1)
2/5/2026, 6:20:45 PM
OpenHealth AI
I'm sorry to hear about your mother's ongoing struggle with strep throat and the frustration that comes with it. Persistent symptoms after treatment can be concerning, especially at her age. Here’s a summary of the situation, an explanation of what might be happening, and next steps you can take.
Summary of Main Points:
- Your mother has been treated for strep throat but is still experiencing significant symptoms.
- Current symptoms include swollen lymph nodes and a lack of improvement with antibiotics.
- A CT scan has been ordered, and you're uncertain about its necessity.
Explanation:
After a positive test for strep throat, treatment typically begins with antibiotics, such as penicillin or alternatives for those allergic to penicillin. The absence of improvement after several courses can indicate a few possibilities:
- Resistance or Incorrect Diagnosis: The bacteria causing her symptoms may be resistant to the antibiotics prescribed, or there could be another issue causing her symptoms.
- Complications: Swollen lymph nodes may suggest an infection that hasn't fully responded to the antibiotics or could indicate a secondary infection or other complications.
- Misdiagnosis: While strep throat was confirmed initially, other conditions like viral infections or different bacterial infections could mimic strep throat symptoms.
The CT scan can help assess the lymph nodes and look for any signs of complications, such as an abscess or deeper infections. While it's understandable to have reservations about its necessity, this step might provide crucial information to guide further treatment.
Prioritized Next Steps:
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Monitor Symptoms: Keep a close eye on her symptoms, especially any new developments like difficulty swallowing, fever, or persistent pain. Documenting these changes can help her doctor understand the severity.
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Stay Hydrated and Rest: Encourage her to drink plenty of fluids and get adequate rest. This supports recovery, regardless of the underlying cause.
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Maintain Communication with her Doctor: If her condition doesn't improve post-scan or worsens, ensure she communicates openly with her healthcare provider about her concerns and the lack of improvement. This includes discussing the results of the throat culture as soon as they are available.
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Consider a Second Opinion: If her situation remains unchanged, a second opinion from an ear, nose, and throat (ENT) specialist may provide alternative insights or treatment options.
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Plan for Follow-Up: After the CT scan, ensure there is a plan for a follow-up visit to discuss the results and next steps, based on what the scan reveals.
I hope this information is helpful, and I'm here to support you as you navigate this challenging situation. If you have further questions or need clarification, feel free to ask.
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