Patient: Red tonsils, White spots, tiny fever, fatigue, hurst when I swallow. Started antibiotics 36 hours ago (augmentin), but I still don’t notice a noticeable difference. I can still see white spots, and still hurts when I swallow. Is this normal? Shouldn’t pain AND.OR white spots be gone by now? Can I do a strep test now, or it is too late since I started antibiotics already? I have uploaded both pictures of now and 36 hours ago.
Doctor: Most cases of pharyngitis is viral in origin but the pictures that you have attached suggest a bacterial infection. I do understand your concern for strep throat because of the potential risk of rheumatic heart disease and glomerulonephritis.Strep throat can be suspected clinically. If there is presence of sore throat, tonsillar exudate, enlarged cervical lymph nodes and a temperature more than 100 F, this indicates a streptococcal infection and justifies empirical antibiotic treatment. If 2 or 3 of the mentioned signs are present then culture or rapid test for group A streptococcus is warranted. Penicillin is the drug of choice, though amoxicillin may be considered too because of its palatability as compared to penicillin. The antibiotics may shorten the period of the symptoms but may not provide relief for the symptoms of sore throat. NSAIDS and acetaminophen are more effective for the treatment of sore throat. If you notice your symptoms worsening after 5 days of therapy then you may need to see your doctor for re-evaluation and to rule out development of an abscess.