Choice “D” is the best answer. This patient has a presentation consistent with a peritonsillar abscess. Peritonsillar abscesses (PTAs) are common account for approximately 30% of soft tissue head and neck abscesses. Signs and symptoms of a peritonsillar abscess include fever, malaise, headaches, neck pain, dysphagia, unilateral pharyngeal discomfort, hoarseness (“hot potato” or muffled voice), otalgia, odynophagia and trismus. Physical exam often reveals a patient in mild to moderate distress with dehydration, drooling (trouble handling oral secretions), trismus, halitosis, cervical lymphadenitis in the anterior cervical chain, asymmetric tonsillar hypertrophy, localized flatulence, and contralateral deviation of the uvula to the unaffected side. The oral examination for this patient (labeled in the photo) reveals a displaced uvula to the right side, a bulge of the soft palate on the side of the abscess and marked erythema and exudate over the affected area. The most prominent aerobic pathogen implicated in the development of PTAs is …show more content…
This patient’s Monospot (heterophile antibody test) is negative making EBV infectious mononucleosis an unlikely diagnosis. Pharyngitis is one of the cardinal manifestations of EBV infectious mononucleosis. Exudative pharyngitis may resemble streptococcal pharyngitis. Patients with EBV mononucleosis may present with a pseudomembrane resembling Corynebacterium haemolyticum or Corynebacterium diphtheriae. However, these infections do not have the associated findings that comprise the infectious mononucleosis syndrome (i.e. splenomegaly). It is important to note, that the posterior oropharynx in patients with EBV infectious mononucleosis is uniformly erythematous. Patients with heterophile-negative infectious mononucleosis have minimal or mild nonexudative pharyngitis. Palatal petechiae and uvular edema are usually absent, and exudative pharyngitis is not a feature of these infectious
The EB’s case study said the female patient is 50 years old with symptoms of fever, chills, congestion, three weeks of coughing, shortness of breath when walking. The study implies that the patient is now seeking medical advice due to vital signs recording and the noting of decreased breath sounds and wheezing. She denies smoking and not taking any chronic medication.
The Epstein-Barr virus is a herpes virus that causes infectious mononucleosis (also known as glandular fever). Epstein-Barr virus genes have been identified in tissue samples of approximately 20-50% of individuals with Hodgkin’s disease. However, it is yet to be established whether the Epstein-Barr virus can cause Hodgkin’s disease. The most of people who develop glandular fever will not develop Hodgkin’s disease.
Most cases of mono resolve without complication, but some rarely occur. Complications are tonsillar enlargement, which can cause respiratory obstruction; rupture of spleen; encephalitis, an infection of the brain tissue; Galen-Barer syndrome, a progressive and sequential worsening syndrome of weakness and paralysis; hemolytic anemia, the red blood cells are destroyed; uvetis, an eye involvement; myocarditis, an inflammation of heart muscle; pneumonia; hephritis, a kidney infection; and Reye’s syndrome; a severe neurological syndrome.
A 41-year-old manwith a history of DM was brought to emergency department (ED)due to difficulty in breathing. It was associated with fever, severe sore throat and muffled voice for 2 days duration. He visited a...
Smith brings his 4-year-old to your office with chief complaints of right ear pain, sneezing, mild cough, and low-grade fever of 100 degrees for the last 72 hours. Today, the child is alert, cooperative, and well hydrated. You note a mildly erythemic throat with no exudate, both ears mild pink tympanic membrane with good movement, lungs clear. You diagnose an acute upper respiratory infection, probably viral in nature. Mr. Smith is states that the family is planning a trip out of town starting tomorrow and would like an antibiotic just in case.
There are many symptoms associated with infectious mononucleosis, but the symptoms all depend on the individual. The more common symptoms are fatigue, sore throat, swelling of the lymph nodes and malaise. There is usually a change in the white cells and serum of the blood, but it can only be detected by a special test, known as the Mono Spot or the heterophile test. It is possible that the results of the test remain negative until a few weeks have passed after seeing some symptoms. It is very rare that the test results remain negative through out the duration of the disease.
Infectious Mononucleosis, or more commonly known as “Mono” for short, is a relatively common illness among young adults. The term "mononucleosis" is a reference to the increase in your body’s mononuclear white blood cells (or lymphocytes) in your bloodstream, which is due to the EBV infection. This illness can leave you feeling extremely tired, can spike a slight fever, sore throat, and swollen lymph nodes. A persons tonsils can have a whitish coating. This is common in at least one-third of reported Mono cases. About 5% of patients develop a splotchy red rash on multiple parts of the body. This rash can have a similar appearance to a rash that is caused by Measles. Early in the course of disease, which is the first few days, a temporary swelling of both upper eyelids could also appear. Mono can also cause an inflammation of the liver and an enlargement of the spleen has been found in about 50% of patients. These symptoms can last for a range of four to eight weeks after the diagnosis. Rigorous activity and contact sports should also be avoided while having Mono and during the recovery phase after the illness is gone to prevent issues with a person’s liver and spleen. Mono is also well-known as the “kissing disease” because the virus can be spread through saliva. Patients can continue to have virus particles present in their saliva for as long as 18 months after the initial infection. Other ways to spread Mono include, but are not limited to, coughing, sneezing, and sometimes can even be spread through an infected persons’ tears. If you have mono, you can avoid giving the virus to others by not kissing anyone and by not sharing drinks, eating utensils, or toothbrushes.
Chest auscultation reveals wheezes and decreased to absent breath sounds over the lower lung bases. Hyperresonance was noted upon percussion of the chest wall. Chest x-ray showed atelectasis in the lower lung bases. The patient has a cough with minimal amounts of clear sputum production.
Examination revealed an oxygen saturation of 96% and chest auscultation was clear. The was no cervical lymphadenopathy or obvious hepatosplenomegaly. On the left leg there was a circular mildly??? erythematous area that was non-blanching.
A 26 year old female patient presents to the urgent care with a chief complaint of a" wet and painful left ear." The onset of symptoms began 24 hours after she spent the day swimming in her family pool. The patient states experiencing ear fullness and itching, that is unrelieved even after she cleaned her ear with a cotton swab. Upon examination with the otoscope, the ARNP notices a erythematous ear canal with a moderate tympanic membrane edema and a clear exudate. The external surrounding tissue is mildly tender to touch and normal vital signs WNL.
Scalp and hair are wet and wave. Eyes: PERRLA with EOMs intact, active red reflex, sclera white in color, no cataracts or hemorrhage noted. Ears: Tympanic membrane patent, intact bilateral without bulging, no erythema or effusion noted. Nasopharynx: Patent, pink, moist oral mucosa, and no enlargement of nasal turbinates. Throat: soft and hard palate intact, non-tender, tonsils without enlargement, non-tender, and erythema Good dental hygiene.
Merriam-Webster defines mononucleosis as: "an acute infectious disease associated with Epstein-Barr virus (EBV) and characterized by fever, swelling of lymph nodes, and lymphocytosis."1 It is more commonly called "mono," or "the kissing disease." When I was thirteen, I caught this dreaded disease, and it changed the ways I acted around my friends forever.
With the advent of the Hib vaccine, the incidence of epiglottitis has decreased, but the condition has not been eliminated.
Infectious mononucleosis (colloquially known as mono) is frequently called the kissing disease. The virus that causes mono is called Epstein-Barr virus (EBV), which is one of the multiple human herpes viruses that are carried asymptomatically by most people. Primary infection is particularly usual in childhood and establishes a lifelong carrier state where the virus remains latent. The EBV replicates frequently in the oropharyngeal epithelial cells and circulating B-lymphocytes, since they are the principal targets of the virus.
It is an opportunistic pneumonia fungal infection caused by Pneumocystis jiroveci. While technically a fungal infection, antifungals have shown to be ineffective against it, so the treatment requires antibiotics and short term steroid use in HIV/AIDS patients. The PJP was causing his shortness of breath and cough.