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An 18-year-old male with a history of recurrent pharyngitis presents to your clinic with fever, sore throat and decreased oral intake. The patient states that his symptoms have been present for about 1-week, although over the past couple of days they have gotten much worse. The patient's vital signs are as follows: temperature is 102.2 deg F (39.0 deg C), pulse is 94/min, blood pressure is 110/68 mmHg and respirations are 14/min. On physical exam the patient appears uncomfortable, barely opening his mouth when speaking. There is tender lymphadenopathy bilaterally. Examination of the oropharynx is demonstrated in Figure A. A heterophile test is performed and later comes back negative. What is the most likely diagnosis in this patient?
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A 12-year-old boy presents with a fever and a sore throat. He is generally healthy; however, he has had a sore throat that he states has required drainage 3 times in the past several weeks. His symptoms keep recurring several days later. Otherwise, the patient is not currently taking any medications and is up to date on his vaccinations. His temperature is 100.5°F (38.1°C), blood pressure is 104/64 mmHg, pulse is 115/min, respirations are 22/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding in Figure A. Which of the following is the most appropriate treatment for this patient?
Incision and drainage
Observation and reassurance