USMLE case: surgery or medicine
A 13-year-old boy has a 3-day history of low-grade fever, upper respiratory symptoms, and a sore throat. A few hours before his presentation to the emergency room, he has an abrupt onset of high fever, difficulty swallowing, and poor handling of his secretions. He indicates that he has a marked worsening in the severity of his sore throat. His pharynx has a fluctuant bulge in the posterior wall. Which of the following is the most appropriate initial therapy for this patient?
A.Narcotic analgesics
B.Trial of oral penicillin V
C.Surgical consultation for incision and drainage under general anesthesia
D.Rapid streptococcal screen
E.Monospot test
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