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Mindy Harris Case Solution

Question 1


A sore throat is a common condition seen in the outpatients. However, the patient’s condition seems different than common, since he has afever for last 5-6 days, and he is also using ibuprofen twice a day. But, medicines are not helping him out. Meanwhile, following are differentials for this problem.

  • -Viruses


->Adenovirus infection

->Influenza A and B

->Human herpesvirus (HHV) 6


  • -Bacteria

->GABHS infection

->Scarlet fever

->Corynebacterium diphtheria


->Chlamydophila pneumoniae

->Streptococcus pyogenes

->Lyme Disease

  • Noninfectious Causes of Sore Throat

-Persistent Cough

-Postnasal drip

-Gastroesophageal Reflux Disease (GERD)

-Acute Thyroiditis






These are the differentials of a sore throat. As far as the fever is concerned, then thepatient’s condition is very unusual. Because the continuous fever associated with the throat pain could be very serious for the patient. However, yet it is not clear what could be the possible causes ofa sore throat, whether it be virus, bacteria or noninfectious causes.

However, most of the time, a sore throat is caused by viral illnesses, and is also responsive to antibiotics, and may cause fever, headache, cough, and runny nose. However, from the patient’s conditions, it can be determined that he has afever of 103, which is high for the sore throat patients.This indicates that patient is suffering from something more complex than asore throat.

Furthermore, the patient has a fever of more than 101 F (38.3C), lasting from 6-7 days, thepatient also cannot eat something and has aproblem to swallow, since he has decreased fluids and is not drinking much, and also has Nausea and thus is unable to eat. On the other hand, the patient also indicates that he has joint pains since he might be feeling body aches.Since the symptoms are indicating the patient is possibly suffering from sore throat.

Question 2

Yes, the patient should present all his medical history, including any disease that he has suffered in recent year, and treatment he was given. Although, all symptoms are indicating that that patient is suffering from a serious illness. That has caused many problems including some rare conditions. Since the redness of eyes, swelling are very rare symptoms found in children. On the other hand, thepatient also has aproblem in the throat and has joint pain. These symptoms make conditions worse than it looks.

Therefore, it is recommended that patient should provide all treatment and disease history since childhood. However, the symptoms indicate that delay in the treatment might causecardioproblems because the feet swelling could result from blood flowing to thefeetindicating thatheart is disturbed and caused the feet to swell. Since the disease can be genetic. Thus, the medical history of the patient needs to go with the diagnosis. Consequently, the symptoms may cause further damage to the health of the patient.

Question 3

However, after the physical examination of the patient. It is determined that patient is underserious problem.Pharynx is markedly red without exudate, including oral mucosa which is also dry indicating that patient has somehow developed a mouth problem that has given redness in the mouth, indicating that it is a rare condition. On the other hand, patient’s mouth is also dry. Following differentials are added into differential diagnosis

  • Scarlet fever
  • Leptospirosis
  • Lyme Disease

Since scarlet fever doescause high fever, chills, headaches, sore throat, swollen glands in the back of the neck, and also Nausea, althoughsome of its symptoms are found in the patient after examining the physical information of the patient. However, the leptospirosis inflectionalsocauses the fever, redness of eyes, sudden headache, Nausea, and body pain as well.The Leptospirosis might be a problem of the patient. However, the Lyme disease has also been includedinto the list of diagnosis credentials.

Question 4

The CBC test results are abnormal whereas the HGB is lower than the normal levels that could be caused by lownutritional intake. However, the normal levels for the HGB are 13.5 to 17.5. Meanwhile, the white blood count is 16,000, but the normal level of white blood count is from 5,000 to 10,000. However, WBC of the patient is less than the normal, meaning it is abnormal. So, the low WBC indicates that patient has viral infections that have temporarily disrupted the work of bone marrow.  But, there are also other causes of the low WBC that may be animmune deficiency and blood disease.

Similarly, the patient's platelets count is 470,000, which is high than the normal level of the platelets that is from 150,000 to 400,000.High platelets are also resultof the infection or the cancer disease in the human body. Meanwhile, the patient has aninfection in the body in thethroat, and swollen feet. On the other hand, the normal neutrophils level is from 55% to 70%. Whereas the patient has 80% neutrophils whichis high than the normal value. Neutrophils are white blood cells that fight against the infections.................................................

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