Strep Throat

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍sore throatdifficulty swallowing

Symptoms include:

‍sore throat

‍pain with swallowing

‍fever, up to ‍°, over ‍ ‍hoursdays

‍headache, ‍diffuse, ‍persistentintermittent, ‍pressurethrobbing, ‍mild

‍chills

‍loss of appetite

‍nausea

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍sputum, ‍clearwhiteyellowgreen

‍shortness of breath

‍red and swollen tonsils

‍red spots on the roof of the mouth

‍swollen lymph nodes in the neck

‍rash

‍body aches



Worsening factors: ‍none

Alleviating factors: ‍noneacetaminophenibuprofen, ‍effectiveineffective



Contributing factors:

‍exposure to individuals with strep throat

‍aged 3 to 15 years old

no history of: ‍strep throat, ‍tonsillitis, ‍mononucleosis, ‍allergies





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍rashlesions on ‍





ASSESSMENT:

‍Bacterial pharyngitis ‍likelysuspectedpossible

DDx: Group A streptococcal, viral pharyngitis, mononucleosis, tonsilitis, gonococcal pharyngitis, diphtheria, peritonsillar abscess, retropharyngeal abscess, scarlet fever, acute sinusitis, postnasal drip, allergic rhinitis, GERD, laryngopharyngeal reflux, thrush, herpangina, throat cancer, foreign body in the throat, smoking-related irritation





PLAN:

Investigations:

- Rapid strep test

- Throat culture

Treatments:

- ‍Antibiotics

- Ibuprofen or acetaminophen as needed for pain

- Salt water gargles 4 times daily

- Rest and hydration

- Limit contact with children

- School leave for 48 hrs

Further care:

- Follow-up in ‍ ‍daysweeks

- Return if not better after 72 hrs or before if worsens