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When A Sore Throat Benches An Athlete Lessons From A Near Fatal Complication - Page #1
 

Author: Timothy Huang, MD
Co Author #1: Timothy J. Huang
Co Author #2: Gianpaolo Rufo
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Steven Gawrys, DO

Patient Presentation:
20-year-old collegiate soccer player presented to urgent care 1-week history of worsening sore throat, fatigue, drenching night sweats, and swollen glands in the neck.

History:
Patient reported a one-week history of worsening sore throat, fatigue, drenching night sweats, and "swollen glands" in the neck. She had left upper-quadrant discomfort, but denied fever, cough, shortness of breath, chest pain, other gastrointestinal symptoms, rash, or neurologic symptoms. No known sick contacts. Despite rest and hydration, she had limited relief. At the next-day family medicine follow-up, she reported new gum bleeding with brushing and transient pinpoint skin spots. She had a brief nosebleed the night prior, which stopped on its own, and bruising from the squat bar from the previous day. She denied ongoing epistaxis, heavy menses, hematuria, melena, or known family of personal bleeding disorders.

Physical Exam:
Vital signs: temperature 97.2 degrees Fahrenheit, blood pressure 123/81, heart rate 91, oxygen saturation 99%. Overall: non-toxic appearing. Head, eyes, ears, nose, and throat: oropharynx mildly erythematous, no tonsillar exudate, no active mucosal bleeding. Cervical lymph nodes enlarged and tender. Lungs: clear to auscultation. Heart: regular rate and rhythm. Abdomen: soft with left upper quadrant tenderness, no hepatomegaly. Skin: diffuse bruising and petechiae at barbell contact sites. Extremities: without edema, multiple bruises noted on arms and thighs. Neurologic: normal.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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