On examination, the child's temperature was 38.9°C (102°F); heart rate, 152 beats per minute; and respiration rate, 24 breaths per minute. He had nonerythematous fullness of 3 x 3.5 cm on the right side of the anterior neck, along with posterior cervical lymphade-nopathy. One of the lymph nodes was fluctuant. There were no tonsillar exudates, changes of the oral mucosa, rash, or conjunctival injection.The peripheral white blood cell count was 21,600/uL, with 81% neutrophils and 10% lymphocytes, C-reactive protein level was 15.9 mg/dL, and erythrocyte sedimentation rate was 96 mm/hr. Results of blood culture, throat culture, and a rapid streptococcal antigen test were negative.
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