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 A provisional diagnosis is a guess physician makes about a diagnosis but is not sure as more details are needed. A differential is where there is more than one possibility of diagnosis, but then the physician has to determine the actual one and provide an appropriate treatment plan. The provisional diagnosis is acute viral tonsillitis, which happens in combination with an inflammation of the pharynx. It is likely to occur to Riccardo as he still a young adult because it is familiar to them and children. The diagnosis is expected to be acute viral tonsillitis due to the symptoms Ricardo has (Catic et al., 2018). His temperature is high, complains of painful swallowing, and has a sore throat. An enlarged anterior cervical lymph node is seen on his left side during the examination and red tonsils exudate. Since his sister said that he has never had an allergy to antibiotics, penicillin can be prescribed to lower rheumatic fever.

The differential diagnoses can be viral pharyngitis due to the sore throat. Another diagnosis is Epstein-Barr virus because he feels exhausted, having lymph node swelling, and sore throat. It can also be HPIVs since he has a fever and influenza as a result of fatigue, swollen lymph nodes, fever, and sore throat. There are high possibilities that Ricardo has a bacterial infection since he exhibits all the signs for streptococcal infection (Stevens & Bryant, 2016). He has exudates tonsils, not coughing, a high fever, and a swollen lymph node, which are signs for group A streptococcal infection. This infection is primarily treated with antibiotics.

 References

Catic, T., Kapo, B., Pintol, Z., Skopljak, A., Cengic, A., Gojak, R., ... & Jankovic, S. M. (2018). An instrument for rating quality of life related to sore throat in patients suffering from acute pharyngitis or tonsillitis. Materia socio-medica30(1), 43. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234653/

Stevens, D. L., & Bryant, A. E. (2016). Severe group A streptococcal infections. In Streptococcus pyogenes: Basic Biology to Clinical Manifestations [Internet]. University of Oklahoma Health Sciences Center. Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK333425/

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