Strep throat laboratory tests: Difference between revisions
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===Throat culture=== | ===Throat culture=== | ||
Throat culture is the gold standard diagnostic test for group A streptococcal pharyngitis. Individuals with negative rapid antigen detection test and high clinical suspicion of strep throat must be confirmed with throat culture. | Throat culture is the gold standard diagnostic test for group A streptococcal pharyngitis. Individuals with negative rapid antigen detection test and high clinical suspicion of strep throat must be confirmed with throat culture.<ref name="pmid20397147">{{cite journal| author=Sarikaya S, Aktaş C, Ay D, Cetin A, Celikmen F| title=Sensitivity and specificity of rapid antigen detection testing for diagnosing pharyngitis in the emergency department. | journal=Ear Nose Throat J | year= 2010 | volume= 89 | issue= 4 | pages= 180-2 | pmid=20397147 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20397147 }} </ref><ref name="pmid19171607">{{cite journal| author=Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST| title=Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis. | journal=Pediatrics | year= 2009 | volume= 123 | issue= 2 | pages= 437-44 | pmid=19171607 | doi=10.1542/peds.2008-0488 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19171607 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19949185 Review in: Evid Based Med. 2009 Dec;14(6):183] </ref><ref name="pmid25369170">{{cite journal| author=Stewart EH, Davis B, Clemans-Taylor BL, Littenberg B, Estrada CA, Centor RM| title=Rapid antigen group A streptococcus test to diagnose pharyngitis: a systematic review and meta-analysis. | journal=PLoS One | year= 2014 | volume= 9 | issue= 11 | pages= e111727 | pmid=25369170 | doi=10.1371/journal.pone.0111727 | pmc=4219770 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25369170 }} </ref><ref name="pmid7618495">{{cite journal| author=Joslyn SA, Hoekstra GL, Sutherland JE| title=Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis. | journal=J Am Board Fam Pract | year= 1995 | volume= 8 | issue= 3 | pages= 177-82 | pmid=7618495 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7618495 }} </ref><ref name="pmid9745311">{{cite journal| author=Pichichero ME| title=Group A beta-hemolytic streptococcal infections. | journal=Pediatr Rev | year= 1998 | volume= 19 | issue= 9 | pages= 291-302 | pmid=9745311 | doi=10.1542/pir.19-9-291 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9745311 }} </ref> | ||
===GAS serology=== | ===GAS serology=== | ||
There is no role of group A streptococcal serology in the diagnosis of strep throat. | There is no role of group A streptococcal serology in the diagnosis of strep throat. | ||
Revision as of 17:37, 21 October 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
History and clinical examination can be used to diagnosis viral pharyngitis when clear viral symptoms (e.g., cough, rhinorrhea, hoarseness, oral ulcers, conjunctivitis) are present; these patients do not need testing for group A strep. However, clinical examination cannot be used to differentiate viral and group A strep pharyngitis in the absence of viral symptoms, even for experienced clinicians. Group A streptococcal pharyngitis may be diagnosed with the help of rapid antigen detection test (RADT) and throat culture.[1]
Laboratory tests
History and clinical examination can be used to diagnosis viral pharyngitis when clear viral symptoms (e.g., cough, rhinorrhea, hoarseness, oral ulcers, conjunctivitis) are present; these patients do not need testing for group A strep. However, clinical examination cannot be used to differentiate viral and group A strep pharyngitis in the absence of viral symptoms, even for experienced clinicians. Group A streptococcal pharyngitis may be diagnosed with the help of following labortary tests:[1]
Rapid antigen detection test (RADT)
RADTs have higher specificity for group A streptococcal throat but lower sensitvity than throat culture.[2][3][4][5][6]
Throat culture
Throat culture is the gold standard diagnostic test for group A streptococcal pharyngitis. Individuals with negative rapid antigen detection test and high clinical suspicion of strep throat must be confirmed with throat culture.[3][4][5][6][7]
GAS serology
There is no role of group A streptococcal serology in the diagnosis of strep throat.
Molecular assays
Molecular assays such as nucleic acid amplification tests [NAAT], polymerase chain reaction assays [PCR] are not routinely used for detection of Strep throat.
References
- ↑ 1.0 1.1 http://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html Accessed on October 18, 2016
- ↑ Leung AK, Newman R, Kumar A, Davies HD (2006). "Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis". Expert Rev Mol Diagn. 6 (5): 761–6. doi:10.1586/14737159.6.5.761. PMID 17009909.
- ↑ 3.0 3.1 Sarikaya S, Aktaş C, Ay D, Cetin A, Celikmen F (2010). "Sensitivity and specificity of rapid antigen detection testing for diagnosing pharyngitis in the emergency department". Ear Nose Throat J. 89 (4): 180–2. PMID 20397147.
- ↑ 4.0 4.1 Tanz RR, Gerber MA, Kabat W, Rippe J, Seshadri R, Shulman ST (2009). "Performance of a rapid antigen-detection test and throat culture in community pediatric offices: implications for management of pharyngitis". Pediatrics. 123 (2): 437–44. doi:10.1542/peds.2008-0488. PMID 19171607. Review in: Evid Based Med. 2009 Dec;14(6):183
- ↑ 5.0 5.1 Stewart EH, Davis B, Clemans-Taylor BL, Littenberg B, Estrada CA, Centor RM (2014). "Rapid antigen group A streptococcus test to diagnose pharyngitis: a systematic review and meta-analysis". PLoS One. 9 (11): e111727. doi:10.1371/journal.pone.0111727. PMC 4219770. PMID 25369170.
- ↑ 6.0 6.1 Joslyn SA, Hoekstra GL, Sutherland JE (1995). "Rapid antigen detection testing in diagnosing group A beta-hemolytic streptococcal pharyngitis". J Am Board Fam Pract. 8 (3): 177–82. PMID 7618495.
- ↑ Pichichero ME (1998). "Group A beta-hemolytic streptococcal infections". Pediatr Rev. 19 (9): 291–302. doi:10.1542/pir.19-9-291. PMID 9745311.