A 33-year-old previously healthy male presented with a 1-week history of severe sore throat and fever. He had been diagnosed with acute tonsillitis by his primary care physician and, although not allergic to beta-lactams, had been treated empirically with clarithromycin.
On admission he was febrile and dyspneic, with bilateral exudative tonsillitis and symmetrical anterior cervical lymphadenopathy.