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What does my rapid strep test report indicate?

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Posted on Thu, 10 May 2018
Question: Hi,
I had sore throat, and went to get it checked. They took a swab, and sent it in.
I could not wait, so after two days I went to get a rapid strep test at a different clinic. It came back negative, but after an hour they called me, and said there was a faint positive line. I started taking antibiotics. The throat culture originally sent in came back two days later, and it was negative for strep. I'm already on antibiotics. Should I stop? Also, is a faint line on a rapid test, still a line?
doctor
Answered by Dr. Eni (17 minutes later)
Brief Answer:
Stop the antibiotics. Rapid test may have false positives.

Detailed Answer:
Dear patient,
Treatment with antibiotics is not only based on culture, but also on the signs and symptoms. Pus on tonsils, high fever, lack of runny nose and cough, are signs of strep throat, which is treated with antibiotics without culture. Culture only serves to do an antibiogramme and decide which is the best antibiotic.
But if you don't have the above mentioned symptoms, and if the culture is negative for strep, then according to the latest studies, you need to stop antibiotics.
The faint line on a rapid test may be a false positive. Since it is a rapid test, it's accuracy is lower than the culture, and it may give false positive or false negative results.
Hope I have answered your question. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health!
Manoku Eni M.D.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Eni (5 hours later)
That makes complete sense, thank you so much.
Just to be sure, I think initially they weighed in. I had no cough, or runny nose, and had white stuff on tonsils, it was pain and sore throat running down one side. That being said, I lacked the fever.
Does this make any difference in the prognosis?
That would make sense then that they decided to go with antibiotics. But as you say, the throat culture is more sure.
doctor
Answered by Dr. Eni (6 hours later)
Brief Answer:
It makes a difference in the diagnosis. It could be mononucleosis

Detailed Answer:
Dear patient,
The lack of fever is a sign that makes me think about mononucleosis, which is a viral disease that is very similar to strep throat, but in mononucleosis the temperature doesn't go beyond 101F (38,5C). When I think about mononucleosis, I need to check my patient's lymph nodes in the neck and surrounding areas, because they are swollen. In strep throat they are not. And mononucleosis is basically treated with NSAIDs such as ibuprofen, rest and staying hydrated.
So, I guess that the fact that you don't have fever and the culture is negative for strep, it may be more likely that you have mononucleosis and this will go away after 5-6 days. Take care to rest and stay hydrated with soup, drinking water and fruit.

I hope you are even clearer now.
Manoku Eni M.D.
Above answer was peer-reviewed by : Dr. Kampana
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Dr. Eni

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What does my rapid strep test report indicate?

Brief Answer: Stop the antibiotics. Rapid test may have false positives. Detailed Answer: Dear patient, Treatment with antibiotics is not only based on culture, but also on the signs and symptoms. Pus on tonsils, high fever, lack of runny nose and cough, are signs of strep throat, which is treated with antibiotics without culture. Culture only serves to do an antibiogramme and decide which is the best antibiotic. But if you don't have the above mentioned symptoms, and if the culture is negative for strep, then according to the latest studies, you need to stop antibiotics. The faint line on a rapid test may be a false positive. Since it is a rapid test, it's accuracy is lower than the culture, and it may give false positive or false negative results. Hope I have answered your question. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health! Manoku Eni M.D.