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How to diagnose strep                   Suspicion of strep?       Yes?   No?     Rapid Strep   Continue with differential diagnosis   Positive   Negative     Treat Yes? Moderate or severely Sick? No?     Mono Spot   Treat for viral pharyngitis or other differential diagnosis   Positive - Treat for mono and NOT strep unless there is cultured evidence of Strep   Negative - Treat for strep and culture throat