A 7-year-old girl is complaining of sore throat for the last 2 days. Today, she has developed a fever of 38.7 °C, which has been relieved by acetaminophen. On examination, she was... A 7-year-old girl is complaining of sore throat for the last 2 days. Today, she has developed a fever of 38.7 °C, which has been relieved by acetaminophen. On examination, she was found to have tender anterior cervical adenopathy and pharyngeal and tonsillar exudate. The rest of her physical exam is unremarkable. Which of the following is the best next step toward diagnosis: A. Throat culture B. Echocardiography C. Rapid antigen detection test D. Fine needle aspiration for cervical adenopathy Read more

Understand the Problem

The question describes a 7-year-old girl presenting with symptoms suggestive of a possible streptococcal infection (sore throat, fever, cervical adenopathy, tonsillar exudate). It asks what the most appropriate next diagnostic step would be.

More Information

Given the patient's symptoms (sore throat, fever, tonsillar exudates, and tender anterior cervical adenopathy), the most likely diagnosis is acute streptococcal pharyngitis (Strep throat). A rapid antigen detection test is a quick and convenient way to confirm this diagnosis. While a throat culture is also an acceptable method, the rapid antigen detection test provides faster results.

Tips

A common mistake is to think that all sore throats require antibiotics. Most sore throats are caused by viruses and do not benefit from antibiotics. It is important to determine if the sore throat is caused by Group A Streptococcus, as this can lead to complications if left untreated. Also, consider the patient's age when determining the likelihood of strep throat.

Sources

• Sore throat in children - Symptom Checker - Mayo Clinic - mayoclinic.org
• Sore Throat - Seattle Children's - seattlechildrens.org
• Pharyngitis - sore throat - UF Health - ufhealth.org