Introduction
At children’s hospital (CHOP) the ER and clinics are always busy. A 5 year old white male child in good general health and physical condition was presented at the Saturday walk in clinic by his mother. He was brought in because he had a fever, was cranky and had complained of a sore throat for about 24 hours. On physical examination by the attending resident, the patient had a fever of 39 c. He had considerable swelling and drainage of the pharynx and in the conjunctivae. His tonsils were enlarged and coated with a white patchy exudates. He had a red throat and swollen anterior cervical lymph nodes. His ears were clear. His chest sounded clear and he had no additional remarkable findings on routine examination. A rapid strep test run ASAP by the lab was positive. Bacteria grown from a throat swab taken at the time of examination indicated gram positive Beta hemolytic bacteria
Presumptive Diagnosis
Based on the presented data of the patient’s primary examination and the basic symptoms reported to the practitioner, the presumptive diagnosis for the considered patient can be Group “A” Streptococcal Infection ranging from Strep Throat to the Bacterial Tonsillitis.
Diagnostic Testing after Examination
The post-examination testing applicable to the discovered symptoms should include three basic stages (Wright, 2001). First, the exudates from the patient’s tonsils are to be analyzed for the presence/absence of streptococci and any other bacteria (NIAID, 2007). Second, the blood test should be carried out in order to see the severity of the infection at the moment and to determine the urgent treatment measures (NIAID, 2007). Third, the urine test should be carried for the purpose of defining the range to which infection has developed and the extent to which its producers, i. e. probably Group “A” Streptococci are led out by urine (Wright, 2001). The diagnostic testing procedures might either confirm of reject the presumptive diagnosis stated above.
Disease Treatment
Group “A” Streptococcal Infections are considered to be among the most widely spread illness human beings suffer from. According to the data by NIAID (2007), over 10 million occurrences of this infection are observed annually around the globe. Drawing from this, methods of treatment for this illness are also well developed and considerably effective. Wright (2001) argues that penicillin is the most common medicine used for this purpose. There are two major ways of administering penicillin during Group “A” Streptococcal Infections treatment. The first involves the use of penicillin V 25-50 mg/kg/day divided into a 4-dose-per-day schedule for 10 days while the second way consists in administering benzathine penicillin (penicillin G) 25,000 u/kg intramuscular as a single injection (NIAID, 2007; Wright, 2001).
Reasons for the Presumptive Diagnosis
The reasons for the presumptive diagnosis according to which the patient had one of the forms of the Group “A” Streptococcal Infections is based mainly on the symptoms reported and the preliminary examination data. First, the patient reports having fever at the level of 39 C and the feeling of the soar throat, which are common symptoms for Streptococcal Infections on the whole, and Group “A” Streptococcal Infections in particular (NIAID, 2007; Wright, 2001). Second, the examination data reveal that the patient has swollen tonsils covered with the layer of white patchy exudates. This symptom is observed in the number of diseases but in combination with soar throat, fever, and the relatively stable and non-problematic health condition of the patient and absence of any other complaints, the diagnosis of the Group “A” Streptococcal Infection becomes the most probable one.
Serious Consequences in Case of Insufficient/Untimely Treatment
The post-examination diagnostic testing procedures in this case should be carried out urgently. The point, according to NIAID (2007) and Wright (2001), is that Group “A” Streptococcal Infections might have serious consequences if not treated properly and timely. The most dangerous of the consequences range from rheumatic fever and post-streptococcal glomerulonephritis (PSGN or inflammation of kidneys) to cancer and death (NIAID, 2007). Further on, if the treatment is not carried out within 18 days after sore throat symptoms are observed, streptococci might cause a heart disease or the Sydenham chorea also known as St. Vittus dance (NIAID, 2007; Wright, 2001). Thus, urgent examination and fast reaction to the first streptococci infections sings is crucial for preventing the serious consequences and saving the patient’s health and life.
Works Cited
Wright, Wendy. What Is the Recommended Treatment for Bacterial Tonsillitis? Medscape Today, 2001. Web.
NIAID. Group A Streptococcal Infections. National Institute of Allergy and Infectious Diseases, 2007. Web.