Female Student with Fevers, Weakness and Dysphagia

An 18-year-old female student with fevers, weakness, and dysphagia

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.

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DOI: http://dx.doi.org/10.15212/FMCH.2014.0135