1. Rhinosinusitis. Rhinosinusitis is the inflammation of the mucosal lining of one or more of the paranasal sinuses. It is caused by viral or bacterial infection of the sinus cavities. It can also stem from allergic rhinitis. A patient with rhinosinusitis will present with complaints of fever, malaise, HA, sinus pressure, sore throat, purulent nasal discharge, cough, ear pain, and teeth discomfort when grinding them together. Diagnosis is based on patient’s report of symptoms and physical exam findings. This patient has malaise, fever, HA, sinus pressure, sore throat, cough, and tenderness noted when grinding teeth together. Bacterial rhinosinusitis is the final diagnosis for this patient.
2. Strep Pharyngitis. Pharyngitis is the inflammation of the pharynx with exudate present. The most common cause is Group A streptococcal organism. It is a bacterial infection. Patient with bacterial pharyngitis presents with complaints of moderate to high fever, sore throat, dysphagia, malaise, headache, swollen lymph nodes, nausea, and vomiting. Patients with bacterial pharyngitis often do not have cough or nasal symptoms. A culture of the tonsils and pharynx can be performed to check for this organism. Strep pharyngitis was ruled out because her
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Epiglottitis. Epiglottitis is the inflammation of the flap at the base of the tongue that keeps food from entering the trachea. A patient with epiglottitis will have rapid onset of sore throat, fever, cough, difficulty swallowing, and an elevated respiratory rate. This is a rare condition. The patient will usually exhibit drooling and have a muffled voice. Stridor and respiratory distress are also noted due to the airway being obstructed. Epiglottitis can cause complete obstruction of the airway and death, so emergent treatment is essential. This diagnosis was ruled out because the patient’s symptoms are not consistent with this condition. The patient exhibits no signs of respiratory distress, drooling, or airway