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Case: A 10-year-old girl is seen by her pediatrician for a complaint of sore throat, and a low-grade fever (99.6 F). The mother states that the daughter has had a runny nose and a cough for the last few days. On examination, the physician notes that the child's pharynx appears red with white patches, and the tonsils appear swollen, but no exudate is noted. A throat swab is collected for a rapid strep test and for culture. The rapid strep test was negative.On culture, moderate numbers of pinpoint, white colonies with beta hemolysis are noted on the SBAP at 24 hrs incubation. The gram stain report was moderate gram-positive cocci in chains noted.
Question 1. What is the most likely identity of the microorganism?
Question 2. What classic biochemical test/s should be performed to confirm the identity of this microorganism?
Question 3. What would cause the rapid strep screen to be negative, but the culture to be positive?
Question 4. Do the patient's symptoms correlate with the negative strep screen, or with the positive culture? Why?
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