Description

R.F. is a 23-year-old female with a history of mononucleosis at age 15. She presents today with acute pharyngitis, associated fever, a headache, sore throat, difficulty swallowing, and tender cervical lymphadenopathy for the past 2 days. The physical exam is positive for fever of 101.5F orally, (+) chills, bilaterally mild to moderately enlarged tonsils without uvular deviation, prominent tonsillar exudate, posterior pharynx erythematous, tender bilateral anterior cervical lymphadenopathy without nuchal rigidity or hepatosplenomegaly and reporting pain 11/10. The patient reports positive exposure to a sick roommate earlier this week and has not had the annual flu vaccine otherwise up to date. She is in a monogamous relationship and occasionally performs oral sex.