What is the most appropriate management step for a patient presenting with severe sore throat and white plaques in the oropharynx?

In cases of severe sore throat accompanied by white plaques in the oropharynx, the clinical presentation raises suspicion for infectious etiologies. A key consideration is to evaluate for infections such as infectious mononucleosis, commonly caused by Epstein-Barr virus (EBV), but also to assess for other viral infections, including HIV.

An appropriate initial step in the management of a patient with such symptoms is to consider the possibility of HIV, especially if other risk factors are present or if the patient has a history of high-risk behaviors. The presence of white plaques in the oropharynx can indicate opportunistic infections such as oral thrush, which is often seen in immunocompromised patients, including those with advanced HIV infection.

Testing for HIV-1 antibodies using an ELISA is crucial because an early diagnosis can significantly impact the management and treatment options for the patient. In this context, determining the HIV status helps guide further investigation and appropriate therapy, especially if the clinical course suggests an opportunistic infection.

Other options, while they may have relevance in specific clinical scenarios, do not address the immediate concern posed by the patient's symptoms in the context of possible HIV infection as effectively as the ELISA for HIV-1 antibodies. The focus here is on managing