I have white patches in the throat, but my strep test was negative. Please help.

Hi,

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By looking at the history and symptoms, a few things come to my list of differential diagnosis. Before that, I would like to know a few things like whether it is associated with difficulty in swallowing, headache, neck stiffness, etc. As you mentioned you have already taken antibiotics, the streptococcal cause is less likely but cannot be ruled out completely even though titers are nil.

It could be acute on chronic tonsillitis as you also have fever, throat discomfort and body ache. It can be a fungal infection as well especially if your asthmatic and on steroid inhalers. It could be infectious mononucleosis, a kind of viral infection associated with all your symptoms. The possibility is high if there are accompanying swellings in the neck. It usually spreads by kissing. The general mode of management for this would be to gargle salt water at least four to five times daily and drink cold fluids or have ice creams to ease throat pain. Avoid irritating, spicy foods and smoking if you are a smoker.

You can take a combination of Ibuprofen and Paracetamol (Combiflam) thrice daily for five days along with antibiotics. For me, it looks more like chronic tonsillitis. The appropriate antibiotic would be Amoxicillin 500 mg thrice daily for five days. You can also take Rabeprazole 20 mg once daily for seven days in case you feel stomach discomfort because of these medications.

If frequent recurrences of tonsillitis are happening, then it is better to go for surgical removal of tonsils. Your physician will help you with suitable antibiotics after ascertaining the diagnosis. Take care.