When A Sore Throat Becomes Life-threatening

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When A Sore Throat Becomes Life-threatening - Page #1

Author: Travis Kinane, DO Co Author #1: Elizabeth Rothe, MD Senior Editor: Justin Mark Young, MD, FAMSSM Editor: Julia Bruene, MD Patient Presentation: An 18-year-old female Division III hockey player with no significant past medical history presented to the emergency department (ED) with a two-day history of sore throat, cough, and fever. The initial workup, including COVID-19, mononucleosis, influenza, and strep testing, was negative. Her medications included an oral combination contraceptive. Her vaccines were up-to-date, and she had no family history of sudden cardiac death or coagulopathies. After initial evaluation, she was discharged with a diagnosis of viral pharyngitis. History: Five days later, she returned to her primary care provider with worsening symptoms, including new nausea, shortness of breath, and chest pain radiating to both arms. During this visit, she was noted to be hypoxic with an oxygen saturation in the high 80s. Due to her chest pain and low oxygen saturation, she was referred to the ED for further evaluation. Physical Exam: Vitals at second presentation to ED: BP- 140/63, Pulse- 151, Temp- 102.2 F, RR- 60, O2 Sat 87% General: Awake, alert, oriented, mildly distressed. HEENT: dry mucus membranes, erythematous oral pharynx, adenopathy of the neck, left worse than right. Cardiac: sinus tachycardia, no murmurs, rubs or gallops. Pulmonary: Tachypnea, mildly diminished lung sounds in the bases bilaterally. No wheezes or rhonchi. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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