Rosh Pediatrics Practice Exam

What is the recommended treatment for a 6-year-old boy with facial swelling, fever, and preauricular tenderness?

1. Acetaminophen and warm compresses

2. Acyclovir

3. Amoxicillin

4. Azithromycin

The correct answer is: Acetaminophen and warm compresses

The presence of facial swelling, fever, and preauricular tenderness in a 6-year-old boy suggests a likely diagnosis of preauricular cellulitis or possibly conjunctivitis with associated swelling, often due to a bacterial infection such as staphylococcus or streptococcus. In this context, the best initial treatment involves supportive care, which includes the use of acetaminophen to manage fever and discomfort, as well as warm compresses to alleviate swelling and promote drainage. Acetaminophen is effective at reducing fever and pain, making it a suitable choice for symptomatic relief in pediatric patients. Warm compresses can help soothe inflammation and possibly facilitate healing by improving blood flow to the affected area. While antibiotic treatment may eventually be indicated based on the severity and persistence of symptoms, starting with acetaminophen and warm compresses is appropriate to address the immediate discomfort and symptoms in a pediatric patient presenting in this manner. If symptoms do not improve or if there is clinical suspicion of a specific bacterial infection, then an antibiotic could be introduced later based on clinical judgement and potential culture results. In the context of the other provided options, antiviral treatment with acyclovir would only be relevant if there was a suspicion of a viral cause, such as herpes virus, which is