A 17-year-old male presents to a busy emergency room, with a 2-week history of a sore throat. The sore throat is accompanied by recent onset of chills, tactile fevers, fatigue, mild cough, and congestion. Despite trying over-the-counter remedies, he has persistent pain with difficulty opening his mouth. He has limited his daily activities to staying home, and his mother says that his voice sounds softer than usual. He exhibits no drooling, has maintained normal oral intake, and reports no weight loss.
In private, he shares that he is sexually active with male and female partners.
Upon examination, he is febrile with a temperature of 39°C. He has 2+ enlarged tonsils with no sign of abscess, mild trismus, and bilateral anterior cervical lymphadenopathy. His neck is otherwise supple with full range of motion. Initial assessments include imaging and infectious labs, all guiding the next steps in management.
Considering his symptoms, examination findings, and social history, what is the most likely diagnosis? What would be your next step in managing this adolescent patient?
A 17-year-old male presents to a busy emergency room, with a 2-week history of a sore throat. The sore throat is accompanied by recent onset of chills, tactile fevers, fatigue, mild cough, and congestion. Despite trying over-the-counter remedies, he has persistent pain with difficulty opening his mouth. He has limited his daily activities to staying home, and his mother says that his voice sounds softer than usual. He exhibits no drooling, has maintained normal oral intake, and reports no weight loss.
In private, he shares that he is sexually active with male and female partners.
Upon examination, he is febrile with a temperature of 39°C. He has 2+ enlarged tonsils with no sign of abscess, mild trismus, and bilateral anterior cervical lymphadenopathy. His neck is otherwise supple with full range of motion. Initial assessments include imaging and infectious labs, all guiding the next steps in management.
Considering his symptoms, examination findings, and social history, what is the most likely diagnosis? What would be your next step in managing this adolescent patient?