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Strep Cultures


nojo

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Does anyone bother to send a culture for a positive rapid test? We have tested positive so often on the rapid, that the Dr. requires the culture. Occasionally we are negative on a rapid (and then always rapid on a culture). Most times though, (95%) when we are positive on a rapid test, the culture comes back negative, we are told we cannot have strep. How can this be? I have been told this is could be picking up dead cells from a previous infection, but if a previous test (rapid and culture were negative) this should not be true. Could this mean we are just colonized, not infected? (and this could be enough to set off the auto-immune response)

 

Is it safe to assume that most people consider a positive rapid test good enough to treat, so they never send out the culture? It is my understanding that it is exceedingly rare to throw out this many false positives, and I don't believe they are false positives. I think she is sick when we go in for a test.

 

Help me wrap my head around this.

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The only thing I can add if that the one time that the doc had sent out a culture on my daughter w/ a positive strep rapid, it was negative. He only sent it b/c he had already filled out the info on the send-out to the lab. Well my daughter is horrible when it comes to strep testing. The doc did both swabs simultaneously & the explaination from many on here was that it was likely that he did not get a good swabbing. Everyone felt it was good that the "good one" was used for the rapid, so that we got treated on ABX that day. At that time, my daughter had huge welt-like hives all over her body for 3-4 days & not until getting the ABX did she clear-right away. Dr. B also said that the error was likely in the technique of getting a good sample from the pharyngeal wall (especially on a kid that takes 3 people to hold down!)

 

 

Hope this helps-I'll try to post the link to the responses I got when I posted this session.

 

Amy

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The only thing I can add if that the one time that the doc had sent out a culture on my daughter w/ a positive strep rapid, it was negative. He only sent it b/c he had already filled out the info on the send-out to the lab. Well my daughter is horrible when it comes to strep testing. The doc did both swabs simultaneously & the explaination from many on here was that it was likely that he did not get a good swabbing. Everyone felt it was good that the "good one" was used for the rapid, so that we got treated on ABX that day. At that time, my daughter had huge welt-like hives all over her body for 3-4 days & not until getting the ABX did she clear-right away. Dr. B also said that the error was likely in the technique of getting a good sample from the pharyngeal wall (especially on a kid that takes 3 people to hold down!)

 

 

Hope this helps-I'll try to post the link to the responses I got when I posted this session.

 

Amy

 

http://www.latitudes.org/forums/index.php?showtopic=7772&st=0&p=63146&fromsearch=1entry63146

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My kid is hard to swab too. We've had TONS of positive rapids, and no culture was done on those. Cultures sent out on neg. rapid have always come back negative. But, they always use 2 swabs at the same time, in case they need to send out for culture because it is so difficult to swab her. So I never know if the neg. result is from por swabbing or truly neg. My daughter has been considered a carrier....

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My kid is hard to swab too. We've had TONS of positive rapids, and no culture was done on those. Cultures sent out on neg. rapid have always come back negative. But, they always use 2 swabs at the same time, in case they need to send out for culture because it is so difficult to swab her. So I never know if the neg. result is from por swabbing or truly neg. My daughter has been considered a carrier....

 

 

Dr. B said it is never supposed to be done simultaneously, but is almost always by practioners b/c it's uncomfortable-It's gotta be in the technique or the amount of fight in the kid that somehow impacts this result. I was dx. with strep m(& pneumonia) on Monday-Thank God she didn't need a strep test-we just upped her prophylaxis dose up to full strength for a week.

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Thanks for the link to the other post, somehow I missed that. I have our records in front of me. We are making the trip to see Dr. B. I know this has been a recurrent problem for us because for the past year we have done both the rapid and the culture. Here is what I am seeing with the labwork in front of me:

 

I have at least 5 times where the rapid was positive, the culture was negative. In fact, as I look through my records, I never have a positive culture. Even when she got scarlett fever this summer. She had classic rash, 101 fever, and even her hands and feet peeled a few weeks later (it was the worst strep rash ever because they wouldn't give us antibiotics for 3 days!)

 

If my daughter were a carrier, she would test positive every time on the rapid, right? But she doesn't. Sometimes I have taken her in when I'm not sure, and she does test negative on the rapid and the culture. I don't believe that she is a carrier, at least all of the time.

 

We pulled her out of school, and she did better being away from kids until this summer/spring when we were around others. She has been doing much worse since then. When I've been bringing her in, she has been showing definite signs of illness. I believe when she is positive on the rapid, especially when she has not had a recent prior infection, it isn't just dead cells in her throat. I can see a difference in her when she is positive, and when she is not, I know I'm not crazy.

 

I just keep hearing the "culture is the gold standard". We don't do anything else according to protocol, why start now? (lol)

 

I've finally got people to believe we have PANDAS, now they just don't believe we have strep.

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