If a rapid influenza diagnostic test (RIDT) is negative for a patient with influenza-like symptoms, what should be done next?

In the context of managing a patient with influenza-like symptoms who has tested negative for influenza using a rapid influenza diagnostic test (RIDT), confirming the negative result with a molecular assay is the most appropriate next step. Molecular assays, such as reverse transcription polymerase chain reaction (RT-PCR), have higher sensitivity and specificity compared to RIDTs. This means they are more reliable in detecting influenza viruses, especially in cases where a patient presents with strong symptoms but the RIDT result is negative.

The RIDT can sometimes yield false-negative results, particularly in settings where the prevalence of influenza is high or if the sample is collected too early or too late in the disease course. Therefore, utilizing a molecular assay as a follow-up ensures that cases of influenza are not missed, which is critical for appropriate patient management and public health considerations.

In contrast, taking no further action would leave the patient without an accurate diagnosis, potentially leading to complications if they have influenza. Repeating the RIDT might not significantly alter the outcome, as it has limitations in accuracy similar to the first test. Performing a throat swab for viral culture is a viable option; however, it typically has a longer turnaround time and may not be necessary if a more sensitive molecular technique is available and provides quicker