 [ Symptoms ] 23 yr old non smoker w swollen enlarged tonsil hard to swallow but tests showed it is not strep or mono so what is it  i went to see a doctor today but his diagnosis acute pharyngitis does not feel right about 3 wks ago i was diagnosed with strep throat my lymph nodes were very swollen and tender to the touch i had a fever throat was sore and there were white spots on my tonsils no swab test i was on antibiotics for 5 days z pak and prednisone which helped my sore throat came back over a week ago i then noticed a little red bump on my left tonsil that got bigger and now my sore throat is worse help [ Disease ] as you know i cannot see your throat and examine you over the internet and unfortunately your description is really not specific enough for me to even guess a medical provider must see these things first hand a mono test taken early in the course of an illness may not be very accurate so your medical provider should consider doing an ebv titer a very sensitive mono test if the clinical findings warrant it a z pack is not the treatment of choic for strep so perhaps a repeat strep culture is indicated as well not the rapid strep test and while you are at it a cbc complete blood count would be helpful information the vast majority of sore throats are viral but sometimes this virus is mono so this diagnosis needs to be revisited