diagnosis

Althea Newman, a 5-year-old child, is accompanied by her mother to the clinic. Althea's mother reports that her daughter has had fever for two days, along with headache, dry cough, sore throat, and difficulty when swallowing. The mother of the patient denies giving any medicines for her problems. Additionally, Althea's mother disclosed that a student at Althea's school is suffering identical symptoms and is undergoing treated for strep throat. Due to the patient's diminished appetite, the mother reports that she has only been eating popsicles in the morning. Althea has no additional medical conditions and denies having any ear, nose, nausea/vomiting, or breathing difficulties. She reports no dysuria and has had at least one regular void this morning. Her four-year well-child visit was missed (Aquifer, 2021).

Sore Throat

Denies ear pain

No known asthma or allergies

Temperature of 101.6F

Denies rhinorrhea

Normal pregnancy and delivery

Headache

Denies nausea and vomiting

No medication

Pain when swallowing

Denies difficulty breathing

Normal urination

Rash/papules around the trunk, torso, face and neck

Father smokes

Normal on growth charts

Dry cough reported

No known COVID contact

Height 44inch

Had symptoms for two days

Weight 45lbs

Uvula appears inflamed

No other medical history

Enlarged cervical lymph nodes

Mild abdominal discomfort

Loss of appetite

School friend currently taking treatment for strep throat

(Aquifer, 2021)

Althea Newman, a 5-year-old normally healthy girl, is brought to the clinic by her mother, who reports that her daughter has a fever, dry cough, headache, acute stomach discomfort, loss of appetite, sore throat, and pain when swallowing. The patient attends school and lives at home with her parents and younger sister. Father is a smoker. The patient's temperature is 101.60 degrees Fahrenheit today, and she has swollen white patchy tonsils, palatal petechiae, anterior cervical lymphadenopathy, and little red pimples on the face, neck, and trunk. The patient's communication skills and grooming are commensurate with her age. Her friend at school is currently being treated with antibiotics for strep throat (Aquifer, 2021).

Rashes

Red papule diffuse rash around the trunk, torso, face, and neck

Fever

Temperature 101.6F

Anterior and Posterior lymphadenopathy

Enlarged (> 1 x 1 cm), tender anterior cervical lymph nodes bilaterally

Sore throat, pain when swallowing

Enlarged tonsils with patchy white exudate, petechia on the soft palate, uvula midline and inflamed

Exposure to strep throat

Exposure to school friend who is taking treatments for strep.

Fever

Temperature 101.6F

Sore throat, pain when swallowing

Enlarged tonsils, petechiae present and inflamed Uvula midline and inflamed

Dry cough

Lungs clear in all fields bilaterally

Fever

Temperature 101.6F

Lymphadenopathy

Bilaterally enlarged lymph and tender lymph nodes

Sore throat, pain when swallowing

Enlarged tonsils, petechiae present and inflamed Uvula midline and inflamed

Rashes

Red papule diffuse rash around the trunk, torso, face, and neck

Rapid antigen test for group A streptococcus (GAS) (Aquifer 2021).

According to guidelines for the diagnosis of group A streptococcal (GAS) pharyngitis, the use of a rapid antigen detection test (RADT) and/or bacterial culture has been shown to be an excellent predictor for the diagnosis of group A streptococcus (Lou et al, 2019).

Covid 19 PCR testing (Harwood &Sinha 2020).

According to Harwood & Sinha 2020, "unlike conventional procedures, PCR permits direct testing and isolation of samples without the requirement for culturing." The testing provides a speedy and highly specific result (Harwood &Sinha 2020).

Monospot (Marshall-Andon & Heinz, 2017)

Heterophile antibody tests are fast acting and affordable, this is a test normally done during the early stage’s symptoms of infectious mononucleosis (Marshall-Andon & Heinz, 2017)

Penicillin V 250 mg by mouth administered three times daily for 10 days (Aquifer, 2021)

When treating persons with acute sore throat or a likely diagnosis of GABHS, the suggested treatment guideline is to utilize penicillin as the first-line medication. However, penicillin allergy must be addressed while selecting an antibiotic treatment for a patient (Driel et al, 2016).

Supportive care for Covid Pediatric patients (Harwood &Sinha 2020).

As advised by numerous studies, all pediatric patients with COVID-19 should get supportive care, including the use of NSAIDS, supplemental oxygen, and nebulizer treatments based on the severity of cases (Harwood &Sinha 2020).

Children’s Tylenol [chewable tablet] 1.5 tabs PO q4h as needed – Max of 7.5 tabs/ 24 hours OR [Liquid] 7.5 ml PO q4 hour—Max 37.5ml /24 hours

Do not take more than 75mg/kg/day. (Aquifer, 2021)

To control and reduce patients’ fever and treat pain.

Educate the mother on the significance of antibiotic treatment completion. Encourage adequate fluid intake, dietary consumption, and rest (Balfour et al, 2015)

Taking antibiotic as prescribed ensures that all disease-causing germs are eradicated or stopped from proliferating.

To prevent dehydration, which can cause severe sickness issues, encouraging patients to consume food and fluids can enhance their strength (Balfour et al,2015).

Inform the mother that the child should not return to school until 24 hours after the fever has subsided.

This is necessary so that she does not infect other students at school.

Educate the mother about the significance of follow-up and adherence to preventive vaccine and wellness recommendations.

To grow and thrive while avoiding illness or diseases.