QuestionOn lats Sunday I went to urgent care because the lymph nodes under my neck were 2 1/2 times the normal size (boyfriends a nurse and he noticed). The Dr. looked at my tonsils and commented on the white spots all over them. he asked if I had a fever and I said no. He did a step test, came back negative. So he decided to put me on Azithromycin.
Here is the problem. That was sunday, today is late tuesday and I have been taking the meds. but see no change. I have actually had a fever now of 101 to 102 for 2 days. I have had step about 4 times in my childhood and tonsilitous once, and about 3 years ago when I was a freshman in college I had mono. Any suggestions on what this could be?
AnswerHi Ms. Ann,
Without examining it, I am unable to provide you with a proper advisory. I really question the need of Azithromycin if it was not due to a bacterial infection. Unless you are allergic to penicillin, we usually do not prescribe it as first line therapy as there is a high rate of resistance to azithromycin. Since mononucleosis is a viral infection, you will become a carrier of the virus for life. It is usually dormant and will cause no recurring symptoms if reactivated later in life with an exception of immunodeficiency (i.e. cancer, HIV, etc).
I would recommend that you revisit your physician and have a rapid antigen detection test (RADT) and throat culture/antibiotic sensitivity. Your doctor should have the results of the RADT within minutes of swabbing you.
It could also be caused by other microbial agents like viruses and fungal. Your physician's determination will be based on his/her observation and confirmation with laboratory testings, if warranted.
Regards,
John Thai, MD
