| QUIZ: What if not angina? *solved* |
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| Tuesday, 16 February 2010 21:37 |
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15 yo (year old) male patient with fever of 39 Celsius degrees came to a GP with a throat pain. Examination: Purulent excretion on tonsils and back wall of throat. Submandibular lymphonodes are enlarged bilaterally. After 4 days of Augmentin therapy there is no recovery, rash showed up on his skin, no shock symptoms. Hepatosplenomegaly.
Patient was admitted to infectious diseases ward and following laboratory tests were made: WBC 17.1 10^3/uL RBC 4.70 10^6/uL HGB 14g/dL HCT 40.6% MCV 86.3 fL MCH 29.3 pg RDW 11.8% PLT 188 000 SEG 14% EOS 1.4% BAS 0.5% LYM 73,7% MON 10.4% QUIZ questions: What is the most possible cause of those symptoms? What other tests can you perform? What treatment would you prescribe? |
Comments
no recovery after antibiotic (because it's viral disease) n hepatosplenomeg aly
abt 80% of patients with acute Epstein Barr virus infection treated with antibiotics develop a red, diffuse rash
n patient is a teenager :-) probably he kissed his girlfriend (oral transmision)
from lab test: leukocytosis, lymphocytosis
And there is one more, important but slight abnormality in this lab tests results;-) Which one?
TREATMENT:
only symptomatic and/or supportive treatments
to reduce pain n fever - NSAIDs, paracetamol
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