Strep Throat Infection That Won't Go Away

Question

Hello Doctor,

I've recently had a strep throat infection which was confirmed by a throat culture. I've been on three different antibiotics inside of about a month and a half from the initial onset of symptoms. First round was a Z-Pak which took away all my symptoms, which came back about a week later after finishing the full course. Went on Keflex-took it away yet came back 4 days later. And now I'm on Leviquin. Also at the end of each coarse of antibiotics I was taking Fluconozle as my primary Dr. prescribed.

The strep keeps coming back and I'm not sure why, and I'm on round 3 at this point. Could it be that flora that is wiped out by the antibotics and possibly the white spots on my tonsils which I'm only assuming is thrush causing the strep that is coming back because of this? Or could it be something else, like the zpak or keflex not strong enough. I'm at my wits end, as I'm sure continual use of antibiotics probably isn't that great for my liver. I have hep b too.

My cd4's are 170 and vl is <50.

I'm really trying to get a handle on this and I've asked my dr. but he's in the dark as to why I keep getting the strep throat...it's a pain in the....throat!

Thanks, Strep Boy

Answer

Hi,

Chronic/recurrent strep throat is actually a fairly common problem, even for folks that are HIV negative. Having AIDS and a CD4 count of 170 increases your risk for many types of infection and may delay your recovery because your immune system can't fight along with the antibiotics to completely wipe out the strep. It's possible you could have chronic sinusitis leading to reinfection of your tonsils after a usual course of antibiotics. I would suggest you have an evaluation by an HIV-knowledgeable ENT physician. If your tonsils are chronically infected, they may even need to be removed.

Good luck.

Dr. Bob