A 16-year-old girl presents to the emergency department with a 5-day history of fever, severe sore throat, and dysphagia. Vital signs are temperature 39.2°C, heart rate 102/min, respiratory rate 18/min, blood pressure 118/76 mmHg, and oxygen saturation 98% on room air. On examination, she has bilateral tonsillar enlargement with whitish-gray exudate, mild palatal edema, and cervical lymphadenopathy. Her oropharynx appears erythematous but maintains adequate airway patency. Laboratory studies show white blood cell count of 12,500/μL with 15% atypical lymphocytes. Rapid antigen test for group A Streptococcus is negative. Monospot test is positive. Which of the following complications is this patient at highest risk for developing?

1. A)Scarlet fever rash and glomerulonephritis
2. B)Toxic shock syndrome from superinfection
3. C)Post-streptococcal sequelae including acute rheumatic fever
4. D)Splenic rupture with minor abdominal trauma
5. E)Acute airway obstruction from progressive pharyngeal edemaGABARITO