Children presenting with sore throats accompanied by symptoms highly indicative of a viral illness—such as rhinorrhea, cough, oral ulcers, or hoarse voice—are unlikely to have Group A Streptococcus (GAS) pharyngitis. Given that many children are asymptomatic carriers of GAS, diagnostic testing may result in misdiagnosis and unwarranted antibiotic treatment, as current tests typically cannot differentiate between acute infection and GAS carriage.
Sources:
Cohen JF, et al. Group A Streptococcus pharyngitis in Children: New Perspectives on Rapid Diagnostic Testing and Antimicrobial Stewardship. J Pediatric Infect Dis Soc. 2024 Apr 24;13(4):250-256. PMID: 38456797.
Sauve L, et al. Group A streptococcal pharyngitis: A practical guide to diagnosis and treatment. Paediatr Child Health. 2021 Jul 28;26(5):319-320. PMID: 34336062.
Shapiro DJ, et al. Viral Features and Testing for Streptococcal Pharyngitis. Pediatrics. 2017 May;139(5):e20163403. Epub 2017 Apr 4. PMID: 28557742.