HPI: female medical student with sore throat x 3 days, non-productive cough developing over last 24 hours along with hoarse voice and headache, possibly a subjective fever
sick contacts- numerous kids with strep, RSV and all other sorts of viruses seen and examined in the last week courtesy of her time spent in the Peds ER
cough drops and Advil has been mildly effective. no change in appetite. recent difficulty sleeping due to nasal discharge and cough.
PE: pt looks tired and miserable but not that sick. throat is mildly erythematous and adenoids are visible but without purulent discharge. cervical LNs tender.
DDx:
URI/Laryngitits- unspecified viral, top contenders include:
Steptococcal Pharyngitis - (pt has had strep throat no less that 50 billion times in her life and blames her sensorineural hearing loss on all the antibiotics she took as a kid trying to get rid of the same. pt can swallow without too much difficulty and lack of real fever, appearance of the throat are less suggestive of this dx)
A/P: Most likely viral so therefore no treatment warranted.
Rx: Take the morning off to stay home, drink tea and study. (Pt would not want to get the healthy kids coming for well-visits sick, after all!)
