Persistent Sore Throat for Two Months: Possible Causes and Next Steps - Otolaryngology

More Info

---

Persistent sore throat lasting for two months can be quite distressing, especially following a potential exposure to sexually transmitted infections (STIs) such as HIV or syphilis. However, the negative results from your HIV RT-PCR test at 35 days and the antibody test at 90 days, as well as the negative syphilis test, significantly reduce the likelihood that your sore throat is related to these infections.

There are several potential causes for your ongoing sore throat and tonsillitis-like symptoms. Here are some possibilities:
1. Viral Infections: Many viral infections can cause prolonged sore throat symptoms. Common viruses include those that cause the common cold or influenza. Even after the acute phase of the illness has resolved, some symptoms can linger for weeks.

2. Bacterial Infections: While you mentioned that your tonsillitis is not purulent (not producing pus), it is still possible to have a bacterial infection that may not present with typical symptoms. Streptococcus bacteria, for instance, can cause a sore throat without significant pus formation.

3. Chronic Conditions: Conditions such as allergies, gastroesophageal reflux disease (GERD), or post-nasal drip can lead to chronic throat irritation and soreness. Allergies can cause inflammation in the throat, while GERD can lead to acid irritating the throat.

4. Other Infections: While tuberculosis (TB) primarily affects the lungs, it can also cause extrapulmonary symptoms, including throat discomfort, particularly in immunocompromised individuals. However, TB is less common and would typically present with additional symptoms such as fever, night sweats, and weight loss.

5. Oral Health Issues: Dental problems, such as gum disease or tooth infections, can also cause referred pain to the throat.

Given that you have already consulted an ENT specialist without resolution, it may be beneficial to consider the following steps:
- Further Evaluation: You might want to revisit your ENT specialist or seek a second opinion. They may consider additional tests, such as a throat culture to check for bacterial infections or imaging studies if they suspect structural issues.

- Allergy Testing: If allergies are suspected, seeing an allergist for testing could be helpful. They can identify specific allergens that may be contributing to your symptoms.

- Gastroenterology Consultation: If GERD is a possibility, a gastroenterologist can evaluate your symptoms and may recommend lifestyle changes or medications to manage acid reflux.

- Infectious Disease Specialist: If there is still concern about a viral or atypical infection, an infectious disease specialist may provide further insights and testing options.

In summary, while your negative tests for HIV and syphilis are reassuring, the persistence of your symptoms warrants further investigation into other potential causes. It is crucial to communicate all your symptoms clearly to your healthcare provider, as this will aid in determining the most appropriate next steps for diagnosis and treatment.