Etiology
1. Group A beta-hemolytic streptococcal infection
Signs
1. Fever
  1. Peaks on Day 2
  2. Returns to normal on Day 5-7
2. Chills
3. Headache
4. Vomiting
5. Pharyngitis
  1. Tonsils are hyperemic and edematous, with exudate
  2. Throat is inflamed and covered by a membrane
6. Tongue dorsum with a white exudate
  1. Projecting edematous papillae
7. Rash
  1. Fine papular or punctate lesions
    1. Texture of coarse sandpaper
  2. Rash begins in axillae, groin and neck
    1. Generalizes within 24 hours
  3. Forehead and cheeks appear flushed
  4. Circumoral pallor
Management
1. Penicillin V
2. Amoxicillin
3. Erythromycin (If Penicillin allergic)

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