Strep A Antigen (Rapid Strep Test)

Definition

Detects the group A streptococcus bacterium that causes throat infection (streptococcal pharyngitis). There are two methods:

MethodWhat it looks forTurnaround timeAccuracy
Rapid strep testStrep A antigens10 to 20 minutesLower
Throat cultureThe Strep A bacterium24 to 48 hoursHigher

Purpose

In the presence of sudden, severe sore throat, difficulty swallowing, fever of 38.3 °C or higher, swollen lymph nodes, red tonsils with white patches, or the rough red rash characteristic of scarlet fever.

Results

ResultWhat is done
Rapid test positiveStrep throat infection confirmed, no further testing needed
Rapid test negative but clinical suspicion remainsA throat culture is ordered for confirmation
Culture positiveInfection confirmed, antibiotics needed
Culture negativeA viral infection is considered

Risks and Limitations

The rapid test has a sensitivity limit:

A throat culture sometimes finds infections that the rapid strep test misses, which is particularly important in children and adolescents at risk of rheumatic fever.

In other words, a negative rapid test alone is not sufficient in children.

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