What are the IDSA guidelines for the diagnosis of group A streptococcal (GAS) infections?

Updated: Sep 07, 2018
  • Author: Zartash Zafar Khan, MD, FACP; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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The Infectious Disease Society of America updated its guidelines for the management of group A streptococcal (GAS) pharyngitis in 2012. The key recommendations for diagnosis and treatment are outlined below. [2]


Diagnostic guidelines are as follows:

  • Rapid antigen detection test (RADT) and/or culture should be performed to distinguish between GAS and viral pharyngitis, except when overt viral features such as rhinorrhea, cough, oral ulcers, and/or hoarseness are present.
  • In children and adolescents, negative RADT results should be confirmed with a throat culture.
  • Because of the low incidence of GAS pharyngitis in adults and the exceptionally low risk of subsequent acute rheumatic fever, throat culture after a negative RADT result is unnecessary.

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