School

“A Case of Pharyngitis” by David F. Dean

Copyright 2006 by the National Center for Case Study Teaching in Science.

Originally published 09/08/06 at http://www.sciencecases.org/pharyngitis/pharyngitis.asp

Modified by instructor

Case Presentation

Jason Hornbuckle is not a happy little boy. For the past 24 hours he has complained of pain when he swallows, has a headache, and has vomited twice. His mother decides to take the seven-year-old to his pediatrician. Upon examining Jason, the doctor finds that Jason’s pharynx, tonsils, and uvula are swollen and erythematous and his tonsils are studded with white areas of exudate. He is febrile (102 F) with tender, bilateral, cervical lymphadenopathy. A CBC performed on a sample of Jason’s blood reveals that he has a leukocytosis due to neutrophilia. Jason is diagnosed as having acute bacterial pharyngitis and treated with phenoxymethyl penicillin for five days. A throat swab taken before starting antibiotics grows beta-hemolytic streptococci (Group A). After three days of treatment, Jason’s temperature has returned to normal and he has made an uneventful recovery.

Questions

1. Define sign. Define symptom. In two separate columns, list Jason’s signs and symptoms.

* A sign is what you can physically see, and a symptom is what the patient is telling them what has been going on. He has told them he has pain when he swallows, headache, which would be a symptom, but the sign would be that he vomited twice.

2. Which areas of Jason are indicating inflammatory changes? What are the four cardinal signs of inflammation, and how does each relate to changes in the blood vessels at the site of inflammation?

* His pharynx and tonsils are the places that have indications of being inflamed. Which means his the veins around that tissue and muscle are vasodilates.

3. Describe the results of the CBC. Describe the role neutrophils play in the resolution of a bacterial infection. In the course of...