Reference no: EM133914021

Question

A 19-year-old student presents to the university health center with several days of fever, sore throat, malaise, and a rash that developed today. 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 has persisted. She has worsening sore throat and difficulty swallowing solid foods; she is drinking well. She denies emesis, diarrhea, or sick contacts. She takes an oral contraceptive daily and took two doses of ampicillin yesterday (left over from a prior illness). On examination, she is well developed with a diffuse morbilliform rash. She appears tired but in no distress. Her temperature is 102.2 F (39 C). She has mild supraorbital edema; bilaterally enlarged tonsils that are coated with a shaggy gray exudate; a few petechiae on the palate and uvula; bilateral posterior cervical lymphadenopathy; and a spleen that is palpable 3 cm below the costal margin. Laboratory data include a white blood cell (WBC) count of 17,000 cells/mm3 with 50% lymphocytes, 15% atypical lymphocytes and platelet count of 100,000/mm3.

1. What is the most likely diagnosis?

2. What is the best study to quickly confirm this diagnosis?

3. What is the best management for this condition?

4. What is the expected course of this condition?