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Episode 63 Acne

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Epic Industrial Future by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 62 Pharyngitis

Question 1: Adolescent with red flags after “sore throat”

A 17-year-old previously healthy male presents with 5 days of worsening sore throat, high fevers, and new right-sided neck pain with swelling. A rapid antigen detection test (RADT) for group A Streptococcus done 2 days ago at an urgent care was negative. Today he appears toxic, and there is tenderness along the anterior border of the sternocleidomastoid. Which of the following is the most likely pathogen–complication pairing explaining this presentation?

B. Fusobacterium necrophorum — Lemierre syndrome (internal jugular vein thrombophlebitis with anaerobic septicemia)

Question 2: Testing strategy in a child with suspected GAS

An 8-year-old girl presents with fever (39.3 °C), throat pain, and tonsillar exudates without cough. Her McIsaac score is 3. A point‑of‑care RADT for GAS is negative. Which of the following is the best next step?

B. Send a throat culture (or molecular test if available) to confirm the negative RADT

Question 3: Reemerging pathogen and optimal diagnostic confirmation

A 32-year-old recent immigrant with unknown vaccination status presents with fever, malaise, and severe sore throat. Examination reveals a gray‑white adherent membrane over the pharynx and tender anterior cervical lymphadenopathy. Which diagnostic approach most rapidly and accurately confirms the suspected diagnosis?

B. Duplex real‑time PCR on a throat swab to simultaneously detect Corynebacterium diphtheriae and the toxin‑encoding gene

Paper for Next Week:

Chan, Jonathan J. “Psoriasis: An Update on Topical and Systemic Therapies.” Australian Prescriber 48, no. 3 (June 2025): 87–92. 

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