A patient presented with upper respiratory symptoms (cough, rhinorrhea) and odynophagia, but no fever, cervical lymphadenopathy or tonsillar exudate. At first a diagnosis of viral pharyngitis was made and no antibiotic was given. However, the patient presented 4 days later with painful lymphadenopathy and tonsillar exudates. He was then treated with amoxicilin and appropriate clinical response was observed. Is it possible/common that patients present with secondary streptococcal pharyngitis following viral infection (i.e. common cold)? I've done some research on this and I couldn't find this specific scenario on any literature. Thank you!
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