Rapid strep neg but pedi treating because throat looks very suspicious of strep, but she has no throat pain just high fever. virus or strep?

Strep test: Rapid strep testing has been cited to have a false negative rate of 5-20%, so a patient could test negative and still have infection. In the case of a negative rapid test, a strep culture could be done which generally detects infection with greater reliability but takes 48-72 hrs to result. It is helpful to discuss the treatment approach with your doctor as viruses can also present similarly.

Hard to know: The strep test is generally predictive, but false negative is possible. More information would be needed for a physician to provide a second opinion (duration symptoms, presence/absence cough, etc). Suggest you try out the Virtual Consult feature on HealthTap using either the Prime or Concierge features. Good luck!

Know that: Due to the low sensitivity but high specificity of rapid strep testing, a positive rapid teis is useful in making a strep diagnosis, but a negative test does not rule out strep well. In fact with some rapid tests, up to 30 percent of cases of strep pharyngitis will be missed. Hopefully a culture was sent too. It could be either viral or strep related.