Strep throat laboratory tests
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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.