The Diagnosis Of A Sinister Sore Throat In This Collegiate Basketball Player Is No Lay Up - Page #1

Author: Cameron Davis, MD
Co Author #1: Christopher Tangen DO
Co Author #2: Amanda Weiss Kelly MD
Co Author #3: Susannah Briskin MD
Senior Editor: Natalie Stork, MD
Editor: Kevin Gray, MD

Patient Presentation:
20 year old male collegiate basketball player with history of malaria infection at age 14 who presented with a sore throat and subjective fevers for 3 days. Before returning to practice, his coach requested that he test for COVID-19. He brought himself to urgent care where he was tested for streptococcal pharyngitis, COVID-19, and infectious mononucleosis which all returned negative. He was started on dexamethasone with recommendation to quarantine. The following day he had worsening fever with new cough productive of sputum, hemoptysis, chills, and myalgia. On follow up examination 2 days later, after speaking with the team physician, he returned to urgent care and was recommended transfer to the emergency department for further intervention.

Immigrant from Nigeria, in the US for 6 years. Prior Malaria infection initially self-treated with homeopathic treatment with family prior to standard treatment. Sexually active.

Physical Exam:
Initial physical exam:
Vital Signs: Temperature 99.1 F, HR 119, Resp 18, BP 98/59, O2 98%
Gen: no distress, fatigued
HEENT: TMs clear, posterior oropharynx erythematous with tonsillar exudate and edema, uvula midline
Neck: no lymphadenopathy, no meningismus
Follow up Physical Exam:
VS: Temp 103.6 F, HR 130, Resp 16, BP 109/59, O2 99%, PE otherwise unchanged

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