Question

A 10-year-old girl presents with a sore throat and fever that has lasted 1 day. She appears flushed and moderately ill. Physical examination reveals a temperature of 39°C, tender bilateral anterior cervical lymph nodes that are 1 to 2 cm in the greatest dimension, and erythema and whitish-yellow exudate over enlarged tonsils and the posterior pharynx.

Diagnostic Testing Results:

Fever: 39°C

Cough: No cough present in patient

Cervical nodes: Swollen and tender

Tonsils: Tonsillar swelling or exudate

Patient Referral:

Due to symptoms, patient had their throat swabbed.

1. Based on what you know about GAS, would you have been able to diagnose her quickly from the clinical symptoms only?

2. What are some other tests that could be run on the sample? Which has the quickest turn-around time?

Answer 1

Based on the clinical symptoms like fever, swollen tender cervial nodes, tonsillary swelling and erythema on enlarged tonsils the condition can be primarily diagnosed as Tonsilllitis or as Strep throat. Viral and bactirial infections that being in the throat can lead to painful inflammation of the surrounding nece muscles. Infections trigger the lymphatic system which contains white blood celss that kill invading microbes.

Tests that could be done in patients with such symptoms may be as below,

• Examine the throat for redness, swelling or white spots on the tonsils
• Checking for other symptoms such as a fever, cough, runny nose, rash or stomachache
• Chekcing the ears and nose for other signs of infection
• The sides of neck to be felt to see if the lymph nodes are swollen and tender
• Complete blood cell count (CBC)
• Rapid Strep test