Will someone please put out an All Points Bulletin on Kelly? You can’t get good help these days, apparently. She must be traveling around with her daughter’s soccer team; well fine! Who needs Kelly when I have my own spectacular cases? Let’s see, what do we have here…. There’s the kid with the bad complexion…. no, I don’t think so…. Oh! Here’s one! Tonsilitis! Who doesn’t like tonsilitis? It’s a very popular disease that I think we can all get behind. Okay, so this is the case of Samantha’s daughter whom we shall call…. hmm… you have to get the name right, you know. How about, Maria? No, too ethnic. What about… Inez! Yeah, that’s the ticket!
Okay, so, Samantha wrote to me about her 4 year old daughter, Inez, and here’s what she said:
Last night she came home from a playdate with a scratchy voice and clearing her throat a lot. She coughed in bed with a little old lady cough, hmmmmm-mmmm. From oh, 11 ish to 12ish. This morning more throat clearing coughing and some droopy-ness physically though not in spirit. Around 2:30 she had a fever of 99.9 and took a nap. Woke at 4:30 no fever small appetite. She ate and then gagged some and said she felt like throwing up and her head hurt. Fever returned at 100.8. Still droopy but liked a popsicle.
Weird weather, warm to cool and back. Thunderstorms. Flu going around. At least one kid we know has strep throat. We just started back to school last Wednesday, a short week.
Her oldest sister was away the whole weekend, I know Inez missed her.
Sensation: Dull and achy. bruised. She says she has a heavy dull headache.
She looks peaked. Pale skin chapped lips. Her tonsils are touching and the right one has a red streak through the middle of it. they are not really red otherwise. Tongue is white-ish with a red tip.
A nap helped the fever. A popsicle helped the sore throat.
Slightly clammy skin, fever. clearing throat and coughing. Thirsty for cold water
None. No runny nose, only one pee, no sweat with fever.
She said she was uncomfortable lying down, was a bit restlees. Now she is lying still on the couch with her papa.
She is LESS whiny and bossy than usual. She is in good spirits and is talking to herself and playing in her mind right now. She is much less talkative than usual.
What does the person say?
Just “I don’t feel good”.
What is the person doing?
She is humming and singing to herself. “Twinkle twinkle little star” right now….. She was pacing earlier, but is lying still now.
as high as 100.8 at about 5pm
no, not even with yucky looking tonsils.
What is most striking about the condition or most peculiar?
She is in a good mood though clearly ill.
Is there a diagnosis? For instance, flu, teething, etc.
Probably strep throat.
Describe the patient’s energy
Sleepy, then after a nap restless and pacing then quiet again, now still but talking and humming.
Thirsty for cold water, little sips.
She was better for Cold, she enjoyed a popsicle.
She was restless pacing before the popsicle, now she is lying down happily.
She is warmly dressed but not covered and is always kicking covers off.
Mostly she is a bit sallow, pale.
Yes the big issue is tonsils.She says only that the pain is dull and bruise-y. the tonsils are very swollen so her voice is thick and she grimaces slightly when swallowing. she is clearing her throat and coughing frequently. So, I would say, slight difficulty swallowing.
Her glands are not swollen and she has not complained with her ears at all. She is turning her head normally.
No shooting pains.
No pain on swallowing she “just has to gulp”.
Her tonsils are swollen, touching each other, with the right one having a dark red streak through it. No other colors, no ulcers or white spots.
Yes, she is peeing less than you’d expect, now that you ask. she really has not had much to drink today considering the fever, only little sips. so there is not much intake, still she has only peed twice that I know of since she got up this morning.
When does she take sips?
Only when we remind her so I guess she is really NOT thirsty, she only asked for water when she heard me ask her dad if she looked dehydrated since I realized she has not drunk much all day.
What’s her energy?
She was more stuporous right after her nap, now very present.
She does not currently have a fever.
I just caught her eating butter off the stick, if that helps.
Dave has just reminded me that the last time she had strep we didn’t know it for a while because she was “cheerful” a word he has not seen me type, so that is a good clue.
Yes, please use Inez for the quiz, I will finally know an answer!
Elaine Lewis, DHom, CHom takes online cases. Visit her website at: elainelewis.hpathy.com