Rosh Pediatrics Practice Exam

When considering differential diagnoses, which condition may present similarly to this case but is distinguished by the absence of exudates?

1. Allergic rhinitis

2. Scarlet fever

3. Viral pharyngitis

4. Adenoviruses

The correct answer is: Viral pharyngitis

In cases where there's a concern about sore throat and related symptoms, viral pharyngitis is known to present in a way that may mimic bacterial infections, but it is distinguished by the absence of exudates. In viral pharyngitis, patients often exhibit symptoms like sore throat, fever, and sometimes cough, but they typically do not show the white patches or dots (exudates) that are commonly seen with bacterial infections such as streptococcal pharyngitis. This distinction is crucial for diagnosis and management, as the treatment protocols for viral infections differ significantly from those for bacterial infections. Recognizing that the absence of exudates aligns with viral pharyngitis can aid clinicians significantly in avoiding unnecessary antibiotic prescriptions, which would be inappropriate in this context. Other conditions like allergic rhinitis primarily manifest through nasal symptoms such as sneezing and nasal congestion but do not typically involve sore throat or exudates at all. Scarlet fever, on the other hand, is a bacterial infection associated with streptococcal pharyngitis and presents with characteristic exudates and a classic rash, while adenoviruses can also cause pharyngitis but are typically associated with more systemic symptoms and other findings.