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White Patches On Back Of Throat, Sore Throat, Nasal Congestion, Headache. Negative Strep Test. False Negative?

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Posted on Wed, 13 Jun 2012
Question: Hey my name is XXXXXXX my husband is currently oversees, and his symptoms are: white patches on the back of his throat, sore throat for 3 days now, nasal congestion, and he just developed a headache today. He went to the doctor and was tested for strep but it came back negative, could this has been a false negative? or what else do you think it is? I entered the below about him
Thanks, XXXXXXX
doctor
Answered by Dr. Jasvinder Singh (4 hours later)
Hello XXXXXXX

Thanks for posting your query.

From the symptoms that your husband is having, the possibilities that are coming to my mind:

1)     Bacterial sore throat caused by streptococcal bacteria and diagnosed by a throat culture, a rapid strep test and a blood test ASO titers ( for any previous infection). It is true that false negative tests with rapid strep test can be false negative with a frequency ranging from 4-39%. Therefore, negative test results should be confirmed by throat culture. I suggest you to get a throat culture done for your husband.

2)     Second possibility is of viral sore throat like that is caused by Epstein-Barr virus (EBV), but can also be caused by other organisms such as Cytomegalovirus (CMV).

It is diagnosed by mono spot test (takes only a few minutes, and can be done in a physician's office), Epstein-Barr virus antigen by immunofluorescence and Epstein-Barr virus antibody titers. Most patients recover within 2-4 weeks without medication.

From the symptoms it looks like bacterial sore throat and hence I suggest that you get a repeat rapid strep test, mono spot test and a throat culture done for your husband and let him start with a course of antibiotics till you get the reports of throat culture.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Regards.



Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Jyoti Patil
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Answered by
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Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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White Patches On Back Of Throat, Sore Throat, Nasal Congestion, Headache. Negative Strep Test. False Negative?

Hello XXXXXXX

Thanks for posting your query.

From the symptoms that your husband is having, the possibilities that are coming to my mind:

1)     Bacterial sore throat caused by streptococcal bacteria and diagnosed by a throat culture, a rapid strep test and a blood test ASO titers ( for any previous infection). It is true that false negative tests with rapid strep test can be false negative with a frequency ranging from 4-39%. Therefore, negative test results should be confirmed by throat culture. I suggest you to get a throat culture done for your husband.

2)     Second possibility is of viral sore throat like that is caused by Epstein-Barr virus (EBV), but can also be caused by other organisms such as Cytomegalovirus (CMV).

It is diagnosed by mono spot test (takes only a few minutes, and can be done in a physician's office), Epstein-Barr virus antigen by immunofluorescence and Epstein-Barr virus antibody titers. Most patients recover within 2-4 weeks without medication.

From the symptoms it looks like bacterial sore throat and hence I suggest that you get a repeat rapid strep test, mono spot test and a throat culture done for your husband and let him start with a course of antibiotics till you get the reports of throat culture.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Regards.