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Peds ID Abx QOTW #19 Answer

d) Order EBV serology

e) Test for GAS

• Reactive lymphadenopathy is typically tender, and the patient’s tonsillar and pharyngeal erythema and exudate are suggestive of a pharyngitis
• Common causes of pharyngitis in this age group include Group A Strep and EBV (infectious mononucleosis)
– It is worthwhile testing for these causes as GAS can be treated with antibiotics, and patient education is important for EBV given that symptoms are often prolonged and associated splenomegaly carries risks with contact sports participation
– Treating without testing is not indicated since non-EBV viral pharyngitis is still also a very common cause of these symptoms
• Bartonella, the cause of cat scratch disease, does not typically cause pharyngitis
• Inflammatory markers are nonspecific and unlikely to help in clinical decision making in this patient