Hi my name is jim and my 9yo daughter has had painful swallowing for last 5 days. We suspected strep and was tested in ER and result was (-) and confirmed 48hrs later as (-),too. Since that test she has had spiked fever (+38 degC) but worse for her is painful swallowing. I have assessed her throat and tonsils are swollen red (no white pustules). But this is just not going away with salt water gargle Q2-4hrs,fluids,and bed rest. What is next step? Hx: no allergies.No meds except motrin q8hrs,prn fv for last 3days only. past med hx is none,very healthy soccer player & skier. Onset was fast ( 1day) and does not seem to be resolving. What to R/O? why no response to tx? all vacines are curent &complete.