Chronic Group A Strep

My 21yo daughter presents with Chronic Group A Strep. Diagnosed June 2023 after a mild non specific illness in January 2023. Presented with fatigue, mild sore throat in the mornings, and gastrointestinal bloating and discomfort. ASOT titres were 1108, DNAse B titre was 220, tonsils grade 2. Treated with penicillin 250mg twice daily for 20 months. Tonsils removed March 2024. In February 2025 ASOT was 513, DNase B was 180. No sore throats since recovering from Tonsillectomy. Penicillin ceased February 2025. Sore throats returned and ASOT increased to 561.

Now on Clindamycin 150 twice per day for 6 weeks, then once a day for 2 weeks. Pending a review in 10 weeks.

Reflux scintiscan ordered for the meantime.