Strep Throat - Exams and Tests

SYMPTOMS & TREATMENTS

Strep throat is diagnosed from your medical history, a physical exam of your throat, and a rapid strep test. A throat culture may sometimes be done to confirm the result of the rapid strep test or when your doctor suspects the rapid strep test result was inaccurate.

Current treatment guidelines recommend that your doctor confirm strep throat with a rapid strep test and not just diagnose strep throat from your symptoms.1 But your doctor may begin treatment for strep throat before the result of your throat culture is back if you have 3 or 4 of the following symptoms:4

  • A recent fever of 101F (38.3C) or higher
  • White or yellow spots or coating on the throat or tonsils
  • Swollen or tender lymph nodes on the neck
  • Absence of signs of a cold or upper respiratory infection, such as coughing or sneezing

One or both of the following tests are used to confirm that you have strep throat.

  • Rapid strep test analyzes the bacteria in your throat to see if strep is the cause of your sore throat. The doctor uses a cotton swab to gather cells from the back of your throat for testing.
  • Throat culture is also a test that analyzes cells from the back of your throat. The cells are gathered with a cotton swab and then placed in a container with substances that promote the growth of strep bacteria. If the strep bacteria grow, the culture is positive. If strep bacteria do not grow, the culture is negative.

If symptoms of strep throat are present, it is important to be tested for strep infection. Prompt treatment will reduce the spread of strep throat and may reduce the risk of complications, such as the infection spreading to other parts of your body causing ear or sinus infections or an abscess behind or around your tonsils (peritonsillar abscess).

If you need to be tested for strep throat, the choice between a rapid strep test and a throat culture may not be clear. It may help to discuss with your doctor the advantages and disadvantages of each test. For instance, results from a rapid strep test are available within 10 to 15 minutes, and results from a throat culture may take 1 to 2 days. A throat culture is more accurate.

  • A negative rapid strep test result can mean there are no strep bacteria present. But the rapid strep test can give negative results even when strep bacteria are present (false-negative test results). If the rapid strep test result is negative but strep throat is still suspected, your doctor may order a throat culture to verify the results.
  • If the rapid strep test result is positive, a throat culture is not needed. Antibiotic treatment can be started right away. Antibiotics may not make you well faster. But they shorten the time you are able to spread the disease to others. Antibiotics also lower the risk of spreading the infection to other parts of your body.

Testing is not needed:

  • After antibiotic treatment, unless you still have symptoms. Testing may be done if symptoms return or you have had rheumatic fever and are at risk for it coming back.
  • For a person who was exposed to strep but has no symptoms. For instance, family members of a person who has strep throat do not need to be tested unless they start to have symptoms.

It is possible for a person to carry the strep bacteria and not have any symptoms. If a number of infections occur in the same family, or if there have been severe complications such as rheumatic fever or toxic shock syndrome, it may be helpful to test family members to learn whether they are carriers of strep infection. But it is unusual for a person to catch strep throat from a carrier.2

By: Healthwise StaffLast Revised: July 27, 2010
Medical Review: Sarah Marshall, MD - Family Medicine
Donald R. Mintz, MD - Otolaryngology

1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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