Table of ContentsView AllTable of ContentsConditions That Mimic StrepFalse Negative TestsWhat to Do
Table of ContentsView All
View All
Table of Contents
Conditions That Mimic Strep
False Negative Tests
What to Do
Strep is a common bacterial infection, affecting around 10% to 15% of adults and 15% to 30% of children with asore throat.
If you or your child has a sore throat but tests negative for strep, your healthcare provider will consider other conditions resembling strep, like thecommon coldorflu, to make a diagnosis. Noninfectious causes of sore throats, likeallergiesor acid reflux, will also be considered.
This article will review various illnesses that mimic strep throat. It will also discuss the chances of a false negative strep test and the following steps to take.
urbazon / Getty Images
Strep throat causespharyngitis, the medical term for an inflamed or sore throat. The throat pain associated with strep usually comes on suddenly and worsens when swallowing or talking.
Other symptoms of strep throat are:
Frequent and Rare Strep Throat Symptoms
Several conditions, both infectious and noninfectious, can mimic strep.
Viral Infections
Even though strep is relatively common, especially in children, viral infections are the most common cause of sore throat in all age groups.
Viral illnesses that resemble strep include:
Does COVID-19 Resemble Strep?
A key way to help distinguish strep from COVID-19 (or other respiratory infections) is that the presence of a cough is rare with strep throat.
Other Bacterial Infections
Sore Throat and Cough: Causes and Treatments
Fungal Infections
Oropharyngealcandidiasis(thrush) is a yeast infection of the mouth and throat. White patches inside the mouth and throat are a typical symptom, but there can also be redness and soreness.Although oropharyngeal candidiasis usually occurs in infants, it may occur in older children and adults (especially those using inhaled steroids or who are immunocompromised).
Treatment usually includes topical or systemic antifungal therapy.
Lemierre Syndrome: A Throat Diagnosis Not to Miss
Noninfectious Conditions
Noninfectious causes of a sore throat include:
Why Do I Have a Sore Throat After Surgery?
What Are the Chances of a False Negative Strep Test?
The initial test performed for strep throat evaluation is typically a rapid antigen detection test (RADT). While this test is widely available and provides immediate results, research suggests it may miss around 14% of cases.
If a RADT is negative, follow-up testing with a throat culture is often recommended, especially in children and teenagers.
Results from a throat culture take longer to come back (around one to two days). However, their chances of being false negatives—results indicating there is no infection when there actually is—are much lower than for RADT. Also, a throat culture can identify other bacterial causes of a sore throat.
Can You Buy At-Home Strep Tests?
After a Negative Strep Throat Test: What to Do
If your strep test is negative, a healthcare provider will review your symptoms and perform a medical exam to reach the correct diagnosis.
If the cause of your sore throat is viral,antibioticsare not warranted. They are only given for bacterial causes of sore throat.
Certain viruses, notably the flu, may require anantiviral drug(depending on your risk level for flu complications). Overall though, most viral causes of sore throat can be treated at home.
Examples of at-home therapies to ease a sore throat include:
Other treatments for sore throat depend on the underlying cause. For instance, a healthcare provider may recommend asteroid nasal sprayor anantihistaminefor an allergy-related sore throat.
Likewise, a person with a sore throat from GERD may obtain relief through lifestyle behaviors (like avoiding smoking and fatty/spicy foods) and medication, such as aproton pump inhibitor.
Speak to a Healthcare Provider
Always consult with a healthcare provider before taking any OTC medication to ensure it’s safe and proper for your care.
Summary
Strep throat is a common cause of sore throat (pharyngitis), especially in children. If a strep test is negative, a healthcare provider may confirm the results with a throat culture, considering the rapid test may miss around 14% of cases.
Once strep throat is ruled out, a healthcare provider will consider other diagnoses, notably viral infections like the common cold and flu. A healthcare provider may also diagnose non-infectious causes like allergies, acid reflux, or irritant exposure based on the person’s symptoms.
Treatment of a sore throat is tailored toward the root cause. Strep throat requires an antibiotic; however, most viral cases clear up on their own and can be managed at home.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Flores AR, Caserta MT.Pharyngitis.Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 2015:753–759.e2. doi:10.1016/B978-1-4557-4801-3.00059-X
Centers for Disease Control and Prevention.Group A strep infection.
Sykes EA, Wu V, Beyea MM, Simpson MTW, Beyea JA.Pharyngitis: approach to diagnosis and treatment.Can Fam Physician. 2020;66(4):251-257
Pappas DE.The common cold.Principles and Practice of Pediatric Infectious Diseases. 2018:199–202.e1. doi:10.1016/B978-0-323-40181-4.00026-8
Lee WJ.Common cold and flu.Vitamin C in Human Health and Disease. 2019:89–100. doi:10.1007/978-94-024-1713-5_5
Centers for Disease Control and Prevention.About infectious mononucleosis (mono).
Centers for Disease Control and Prevention.About HIV.
Khalifa C, Slim A, Maroua G, Sioud S, Hentati H, Selmi J.Herpes simplex virus infection: management of primary oral lesions in children.Clin Case Rep. 2022;10(8):10.1002/ccr3.6127. doi:10.1002/ccr3.6127
Center for Disease Control and Prevention.HFMD symptoms and complications.
Luo X, Lv M, Zhang X, et al.COVID-19 evidence and recommendations working group. Clinical manifestations of COVID-19: an overview of 102 systematic reviews with evidence mapping.J Evid Based Med. 2022;15(3):201-215. doi:10.1111/jebm.12483
Mayo Clinic.Gonorrhea.
Taj S, Austin CP, Ahmed Z, et al.Lemierre’s syndrome: a comeback story.Cureus. 2022;14(6):e25843. doi:10.7759/cureus.25843
Alrwashdeh AM, Saluja P, Hasan L, Kocurek E, Dare RK.Arcanobacterium haemolyticumbacteremia presenting as severe sepsis: a case report and review of the literature.IDCases. 2022;31:e01645. doi:10.1016/j.idcr.2022.e01645
Dumke R, Schnee C, Pletz MW, et al.Mycoplasma pneumoniae and Chlamydia spp. infection in community-acquired pneumonia, Germany, 2011-2012.Emerg Infect Dis. 2015;21(3):426-434. doi:10.3201/eid2103.140927
Centers for Disease Control and Prevention.Candidiasis.
Amin KAM.Allergic respiratory inflammation and remodeling.Turk Thorac J. 2015;16(3):133-140. doi:10.5152/ttd.2015.4942
American Society for Gastrointestinal Endoscopy.Understanding gastroesophageal reflux disease.
Aqil M, Khan MU, Mansoor S, Mansoor S, Khokhar RS, Narejo AS.Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope.BMC Anesthesiol.2017;17(1):127. doi:10.1186/s12871-017-0421-4
Cohen JF, Bertille N, Cohen R, Chalumeau M.Rapid antigen detection test for group A streptococcus in children with pharyngitis.Cochrane Database Syst Rev. 2016;7(7):CD010502. doi:10.1002/14651858.CD010502.pub2
Maisonneuve H, Sebo P, Sommer J, Gerner P, Winkler NE, Haller DM.Emploi des remèdes de grand-mère en ORL : la recherche éclaire nos pratiques et celles de nos patients [Use of non-pharmacological home remedies in ENT: research informs our practices and those of our patients].Rev Med Suisse. 2022;18(781):925-929. French. doi:10.53738/REVMED.2022.18.781.925
American Academy of Otolaryngology—Head and Neck Surgery.Sore throats.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
