Case Discussion A 13-year-old boy presents to ED with a cc of sore throat and fever for 2 days. He reports that his younger sister has been ill for the past week with “the same thing.” The patient has pain with swallowing, but no change in voice, drooling, or neck stiffness. He denies any recent history of cough, rash, nausea, vomiting, or diarrhea. He denies any recent travel and has completed the full series of childhood immunizations. He has no other medical problems, takes no medications, and has no allergies. On examination, the patient has a temperature of 38.5°C, a heart rate of 104 beats per minute, blood pressure 118/64 mm Hg, a respiratory rate of 18 breaths per minute, and an oxygen saturation of 99% on room air. His posterior oropharynx reveals erythema with tonsillar exudates without uvular deviation, or significant tonsillar swelling. Neck examination is supple without tenderness of the anterior lymph nodes. Chest and cardiovascular examination is unremarkable. His abdomen is soft and nontender with normal bowel sounds and no hepatosplenomegaly. Skin is without rash. 1....What is the most likely diagnosis? 2....What are the dangerous causes of sore throat you don’t want to miss? 3....What is your diagnostic plan? 4....What is your therapeutic plan?
Posted on: Mon, 18 Aug 2014 05:57:45 +0000
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