A 19-year-old female presented to the hospital with several days of fever, sore throat, malaise, and a rash that developed the same day she reported to the hospital. She first started feeling ill 10 days ago with general malaise, headache, and nausea. Four days ago, she developed a temperature of 103 °F (39.4 °C) that persisted. She had a worsening sore throat and difficulty swallowing solid foods; she was drinking well. She denied emesis, diarrhea, or sick contacts.
She took an oral contraceptive daily and two doses of ampicillin a day before she reported (left over from a prior illness). Examination The patient had a diffuse morbilliform rash. She appeared tired but in no distress. Temperature: 102.2° F (39°C) She had mild supraorbital edema; bilaterally enlarged tonsils that were coated with a shaggy gray exudate; a few petechiae on the palate and uvula; bilateral posterior cervical…
