Caused by strep pyogenes or group A B-hemolytic strep, or viruses (rhinovirus, coronavirus, adenovirus, HSV, parainfluenza)
Mononucleosis differential: splenomegaly, cervical adenopathy. A diffuse rash 2-3 days after PCN dose is indicative of mono.
- If you have to guess a sub for PCN allergic patients in ANYTHING chose a macrolide.
- PCN V or Amoxil for 10 days (alternate: azithromycin for 5 days)
- Cefadroxil, cefixime, cefdinir for 10 days
- Benzathine PCN G times 1 only (be sure they are not allergic before giving)
- If recurrent: clindamycin for 10 days or amoxi/clavulanate for 10 days or Benzathine PCN G