Intense, diffuse pharyngeal erythema and Koplik spots, the pathognomonicenanthem, occur in advance of the characteristic rash ofmeasles. Splenomegaly or hepatomegaly may be the clue to Epstein-Barr virus infectious mononucleosis in an adolescent with exudativetonsillitis. Primary infection with HIV can manifest as the acute retroviralsyndrome, with non-exudative pharyngitis, fever, maculopapularrash, arthralgia, myalgia, adenopathy, and often a maculopapularrash.
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