Group A Strep Testing

A 2 year old presents to clinic with cough + sore throat + x 2 days. Her tonsils are red and swollen without exudate. The does NOT test for Group A Streptococcus. Is this appropriate?

A. Yes, appropriate

B. No, test for GAS

C. A peds question? HELP

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Best Answer

Yes, appropriate

Yes it is appropriate to NOT test for Group A Streptococcus (GAS) 🦠

Testing for GAS is generally not indicated in children < 3. This age group is likely to be colonized with GAS so significance of a ➕test is unclear 🤷🏻‍♀️

If our patient were older, we would consider testing in a patient with symptoms of GAS pharyngitis:

-fever 🤒
-tonsillar exudate
-cervical lymphadenopathy
-no cough

If GAS is confirmed, we’d give 10 days of amoxicillin 💊 to avoid progression to rheumatic fever 😰 Pump the breaks on inappropriate testing for GAS! 🛑