Author: Murtagh, John
An 18-year-old female sought evaluation of lethargy and weakness of 3 days duration. She also complained of fevers with sweating, headaches, nasal blockage, anorexia with two episodes of emesis, and a very sore throat with dysphagia. She had felt ill for the preceding 2 weeks. There has been no contact with persons with infectious diseases.
Medical history: Idiopathic scoliosis; otherwise good health. Surgical history: Appendectomy for appendicitis.
Drug history: Occasional marijuana and alcohol use.
Social history: Lives with parents and an older brother; studies art at the University.
General appearance: Young woman who appears pale and ill; periorbital edema and nasal quality to voice. Pulse, 90/min and regular; BP, 110/70 mmHg; temperature, 38.9°C; respiratory rate, 14/min. Throat: Tonsillar enlargement bilaterally; white-yellow exudate on tonsils bilaterally; petechiae on palate. Lymphadenopathy, especially involving the posterior cervical group. Fine pink maculopapular rash on anterior trunk.