Question

A 22-year old male college student was presented at the ESU health clinic. He looked tired and pale. He presented because of high fever and chest pain. He was afraid he was having a heart attack (bad week of exams). He was examined immediately by the PA and an EKG strip was run. He had no evidence of acute heart problems. The attending physician visited the patient. He obtained the following history from the past 36 hours. The patient had a tight cough. He had significant muscle aches and pains. He had a bad headache and had had fevers of 101 - 103° F. The physician ordered a chest x-ray. It did not show any significant consolidated inflammation suggestive of pneumonia. The patient showed significant nasal drainage and a moderately tight, but productive cough on physical exam. He had a fever of 101° F and generally inflamed mucous membranes. A rapid Strep test showed no evidence of Streptococcal infection and his tonsils and adenoids had been removed. Directions: Answer the following questions in your own words. 1. What is the most likely diagnosis for this patient? On what do you base this diagnosis? 2. What secondary infection problems should be monitored? What is the preferred treatment for this disease?

Answer 1

1. The most likely diagnosis for this patient is Influenza .

Influenza is a viral infection that attacks the respiratory system mainly nose, throat and lungs. Influenza is commonly called as 'flu'. Common signs and symptoms of influenza includes : Fever over 100.4 0 F, muscle aches, chills and sweating, headache, dry or productive cough, fatigue, weakness, nasal congestion and drainage, sore throat etc.

In this case, the patient is having tiredness, high fever of 1010 - 1030 F, chest pain with no evidence of acute heart problems, muscle aches, head ache, No evidence of consolidated inflammation in chest X-ray ( so not suggestive of pneumonia), nasal drainage, productive cough, inflammed mucous membrane, no evidence of Streptococcal infection in rapid strep test. These clinical symptoms suggests that patient is having influenza.

2. If Influenza is left untreated, it will leads to secondary infections. The major secondary infection following influenza is Pneumonia. Pneumonia is the most serious complication. For people having any chronic illness and in older adults, pneumonia can be deadly.

Other complications of influenza includes

• Bronchitis
• Asthma flare-ups
• Heart problems
• Ear infections

3. Preferred treatment and management for influenza includes

• Drink plenty of fluids
• Bed rest
• Eat healthy and light meals
• Anti pyretics for reducing fever
• Analgesics for reducing chest pain and headache
• Anti viral drugs such as Oseltamivir phosphate, Zanamivir etc.
• Avoid close contact with others to prevent the spread of infections.

Most people infected with influenza will recover within two weeks without undergoing any medical treatment. Maintaining adequate fluids and rest are important.