My strep result is positive, but my symptoms are like viral. What to do?

Question

Hi doctor,

During my travel, I had a sore throat, 38.8 °C fever, and back aches. I did not have a stuffy nose or congestion. I previously had a bladder infection three weeks ago and the doctor whom I visited in that place prescribed me Levofloxacin. I think he was treating me for a kidney infection, but due to the language barrier, I was not sure. I took the five-day course of antibiotics and felt better. Three days later the sore throat came back, but no fever. As I came back to my town, I visited my regular GP. She did a throat culture and was prescribed Amoxicillin. Before starting Amox, the sore throat went away and a cough developed with green mucus. Not sure whether it comes from the lungs or the sinuses. I got my strep results today and it is positive. So, I am trying to figure out what is going on. Instead of strep, my symptoms are like a viral infection. Should I need the second round of antibiotics? As a biologist, I tend to overanalyze my sicknesses, sometimes, but I am trying to understand this better. Due to the studies of the irreparable damage to the GI tract of antibiotics, I do not like the idea of being on my second round of antibiotics if this could be viral. And if it was a viral case, is it bad to stop the antibiotics? Please explain.

Answer 1

Hello,

Welcome to icliniq.com. Strep pharyngitis is usually graded by modified center criteria. I do not have all the elements to plug in the numbers. Classically, you should have a fever, exudates on the tonsils and posterior pharynx, cervical lymph node enlargement, and an absence of cough. Your positive culture might be representing that you harbor Strep in your pharynx. Now that the symptoms of sore throat are gone and I would not suggest getting treatment for that reason. Now, a productive cough with green phlegm does not always mean that you have a bacterial infection. By the book when you have symptoms of sinus pressure, congestion, and or fever for a week not improving with conservative treatment that is when we treat with Amoxicillin. If you have any of the mentioned symptoms, then you would benefit from treatment. If you are having chest congestion, which is not improving with conservative treatment getting a chest x-ray and CBC (complete blood count) would be a reasonable option.