Paper Example on Diagnosing HEENT Disorders

Introduction

This is a case of a middle-aged female who presents a claim to the office, she complains of strep throat which as she states she developed it yesterday in the afternoon and has become worse. She felt chilled and furnished during the night. She claims that she had no contact with a person who has strep throat. She has not yet taken any medications and is allergic to penicillin. After conducting the physical examinations, the results showed that she had temperatures of 100 degrees, 112 heart rate, 22 respiratory rates and pressure of blood read as 96/64.

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Diagnosis

Streptococcal pharyngitis-A B hemolytic streptococcus pharyngitis (GABHS) which is an infection which usually affects children but occasionally the adults. The signs and symptoms of this infection include fever with a temperature of the body ranging from 101.5 degrees and above, tonsillar exudate, frontal cervical adenopathy also a history of the exposure recently(Dains, Baumann, and Scheibel,2016). This infection is what constitutes to 10 % of the throat infections that adults usually have, usually have a fever, swelling of the front cervical lymph nodes, the adult with this infection does not have a cough and tonsillar exudate. It is challenging to diagnose GABHS pharyngitis and non-GABHS pharyngitis using clinical strategies only. When differentiating strep throat from viral pharyngitis, a rapid antigen detection test or through culture can be used and should be carried out on this patient (Nakhoul & Hickner, 2013).

Differential Diagnosis

Viral pharyngitis.Patients that are infected with this infection usually have sore throat, malaise, fever, coughing, fatigue and headache. The pharynx can be erythematous without tonsillar enlarging or educating (Dains et al., 2016).

Infectious mononucleosis .this infection is different from pharyngitis or tonsillitis when presented in the clinic, physical examination else serologic finding, and it is more prevalent in adolescents and young adults, commonly known as the kissing disease. The signs and symptoms that are associated with this infection include fatigue, headache, malaise and anorexia before the occurrence of a sore throat. A CBC reveals leukocytosis also positive mono-spot test results will show heterophil antibodies; this is a verification of "mono" (Buttaro, Trybulski, Bailey, & Sandberg-Cook). The Epstein-Barr virus causes this infection. The signs and symptoms of this infection consist of the swollen spine, headaches, sore throat, fever, fatigue, skin rash, swollen tonsils, swollen lymph nodes around the neck also armpits(Niederman, McCollum, Henle, & Henle, 1968). There is no one specific treatment for this infection since antibiotics cannot fight infections caused by the virus. This infection can be treated through several strategies such as taking adequate fluids, bed rest and intake of proper nutrition.

Upper respiratory infection. Which is a sore throat even erythema that may be seen in a URI. Common signs and symptoms of this infection include coughing, running nose, sore throat, congestion of the nose, low-grade fever, sneezing, headache also facial pressure (Buttaro et al., 2013).

History and Physical Examination

Determination of the possible causes and diagnosing patients symptoms by the healthcare provider is done through inquiring from the patient her symptoms, the person she or he has been in contact with, where she had been recently, the things that she had been exposed to, also anything that can aggravate the condition is of importance in identification of these signs and symptoms. To develop an accurate diagnosis for a description of appropriate diagnostic tests and proper treatment requires a thorough history and physical examination (Dains et al., 2016). The case study information revealed that she had a sore throat that she had developed yesterday and was getting worse. She felt like she was chilled and feverish at night.Her temperature was 1001 degrees, heart rate 12, respiratory rate 22 and pressure of blood reading 96/64. Her neck is supple with bilateral even enlarged anterior cervical nodes.

Treatment options

If the tests carried out is positive, a patient can be given an alternative for penicillin.Penicillin is the best treatment for strep throat (Nakhoul & Hickner, 2013). Treating viral and bacterial pharyngitis should include treating symptoms such as voice test, warm saline gargles, fluids, Acetaminophen, humidification or ibuprofen, throat lozenges and anaesthetic spray. The patient has allergy for penicillin thus will be given either Keflex 500mg BID for x 10 days or Erythromycin. Azithromycin at a dosage of 12 mg/kg/day for a maximum of five days. Encourage patients to take a lot of fluid for the prevention of dehydration.

References

Buttaro, T. M., Trybulski, J., Polgar, Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th Ed.). St. Louis, MO: Mosby.

Dains, J. E., Baumann, L. C., & Seibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th Ed.). St. Louis, MO: Elsevier Mosby.

Nakhoul, G. N., & Hickner, J. (2013). Management of adults with acute streptococcal pharyngitis: minimum value for backup strep testing and overuse of antibiotics.Journal Of General Internal Medicine, 28(6), 830-834. doi:10.1007/s11606-012-2245-8.Retrieved from https://link.springer.com/article/10.1007/s11606-012-2245-8

Niederman, J. C., McCollum, R. W., Henle, G., & Henle, W. (1968). Infectious mononucleosis: clinical manifestations about EB virus antibodies. Jama, 203(3), 205-209.Retrieved from https://jamanetwork.com/journals/jama/article-abstract/337384