Family Medicine 21 12-Year-Old Female with Fever Name xxx United State University Course xxxx Instructor xxxxx Date : xxxx Family Medicine 21 12-Year-Old Female with Fever Patient History of Present Illness Marissa Payne is a female patient who is 12 years old and has complaints of cough, fever, sore throat, muscle aches, and headaches over the past three days. She has not had contact with a sick person. There are no crackles in the cervical lymphadenopathy, but there is a hyperemic oropharynx, occasional wheezes, and generalized rhonchi on physical examination. She has not been immunized against COVID-19 and the influenza virus. Differential Diagnoses In this case, influenza is the primary diagnosis. Influenza is associated with symptoms in the infection of the respiratory tracts, as well as systemic symptoms like myalgia, headache, fever, and fatigue (Mayo Clinic, 2021). Children with influenza often have headaches, sore throats, and a general feeling of malaise before their upper respiratory symptoms, like coughing, show up (Mayo Clinic, 2021). It is common for patients to be able to pinpoint the exact hour of influenza's onset. Winter is a common time for outbreaks to occur. In some adults and children, headache is the initial symptom. Young children commonly have a fever above 102.2 °F (Mayo Clinic, 2021). On the other hand, older children may appear with a jumble of symptoms, making it difficult to tell if they have influenza (Mayo Clinic, 2021). Fever-induced seizures can occur in infants as young as six months old. Flu symptoms might induce rhonchi on a lung exam. Rhonchi are a side effect of influenza and not one of the most important things that a practitioner looks for when someone has the flu (Mayo Clinic, 2021). Influenza mostly affects a greater percentage of preschool and school-aged youngsters each year (Mayo Clinic, 2021). Children under the age of two are more likely to experience complications and need hospitalization (Mayo Clinic, 2021). It is possible that Marissa's aches and pains are a sign of influenza. Marissa has a sore throat, which does not necessarily mean she has influenza, but it is part of a larger set of symptoms that are not prevalent in other diseases. Group A streptococcal pharyngitis is another possible diagnosis. This infection causes fever, sore throat, lack of cough, and sensitive lymphadenopathy of the cervical region are the most common symptoms (Arnold & Nizet, 2018). Group A streptococcal pharyngitis could be a possibility, but considering Marissa's other symptoms and the discovery of painful cervical lymphadenopathy, this appears less plausible than it might seem. Acute bronchitis is the other possible diagnosis. Acute bronchitis is coughing due to inflammation of the major airways in the lungs Sputum with purulent content is found in 50% of patients with inflammation of the tracheobronchial system (Singh et al., 2022). Viruses are the most common cause. It is difficult to tell the difference ...

1. Family Medicine 21 12-Year-Old Female with Fever
Name xxx
United State University
Course xxxx
Instructor xxxxx
Date : xxxx
Family Medicine 21 12-Year-Old Female with Fever
Patient History of Present Illness
Marissa Payne is a female patient who is 12 years old and has
complaints of cough, fever, sore throat, muscle aches, and
headaches over the past three days. She has not had contact
with a sick person. There are no crackles in the cervical
lymphadenopathy, but there is a hyperemic oropharynx,
occasional wheezes, and generalized rhonchi on physical
examination. She has not been immunized against COVID-19
and the influenza virus.
Differential Diagnoses
In this case, influenza is the primary diagnosis. Influenza is
associated with symptoms in the infection of the respiratory
tracts, as well as systemic symptoms like myalgia,
headache, fever, and fatigue (Mayo Clinic, 2021). Children with
influenza often have headaches, sore throats, and a general
feeling of malaise before their upper respiratory sympto ms, like
coughing, show up (Mayo Clinic, 2021). It is common for
patients to be able to pinpoint the exact hour of influenza's
onset. Winter is a common time for outbreaks to occur. In some
adults and children, headache is the initial symptom. Young
children commonly have a fever above 102.2 °F (Mayo Clinic,
2021).
On the other hand, older children may appear with a jumble of
symptoms, making it difficult to tell if they have influenza

2. (Mayo Clinic, 2021). Fever-induced seizures can occur in
infants as young as six months old. Flu symptoms might induce
rhonchi on a lung exam. Rhonchi are a side effect of influenza
and not one of the most important things that a practitioner
looks for when someone has the flu (Mayo Clinic, 2021).
Influenza mostly affects a greater percentage of preschool and
school-aged youngsters each year (Mayo Clinic, 2021). Children
under the age of two are more likely to experience
complications and need hospitalization (Mayo Clinic, 2021). It
is possible that Marissa's aches and pains are a sign of
influenza. Marissa has a sore throat, which does not necessarily
mean she has influenza, but it is part of a larger set of
symptoms that are not prevalent in other diseases.
Group A streptococcal pharyngitis is another possible diagnosis.
This infection causes fever, sore throat, lack of cough, and
sensitive lymphadenopathy of the cervical region are the most
common symptoms (Arnold & Nizet, 2018). Group A
streptococcal pharyngitis could be a possibility, but considering
Marissa's other symptoms and the discovery of painful cervical
lymphadenopathy, this appears less plausible than it might
seem.
Acute bronchitis is the other possible diagnosis. Acute
bronchitis is coughing due to inflammation of the major airways
in the lungs Sputum with purulent content is found in 50% of
patients with inflammation of the tracheobronchial system
(Singh et al., 2022). Viruses are the most common cause. It is
difficult to tell the difference between a URI and acute
bronchitis in the first few days. When it comes to acute
bronchitis, a cough that lasts longer than five days is common
(Singh et al., 2022). Patients with bronchitis can have rhonchi,
scattered wheezes, or a normal lung exam, depending on the
severity of their illness (Singh et al., 2022). When the bi g
airways are inflamed or mucus-filled, they produce rhonchi, a
series of pulsating sounds (Singh et al., 2022). In this case,
Marissa is experiencing signs of acute bronchitis, including
coughing, fever, and rhonchi; however, her other symptoms,

3. including headache, myalgia, and sore throat, cannot be
explained by this condition.
Diagnostic Tests
To confirm the primary differential diagnosis, tests are
recommended. Therefore, in this case, we need a rapid influenza
test to confirm the presence of influenza (CDC, 2019). The
rapid influenza lab result is positive. Also, a rapid test for
group A Streptococcus is recommended to rule out
Streptococcal Pharyngitis whereby the results are negative
hence ruling out group A Streptococcal Pharyngitis (Luo et al.,
2019). On the other hand, a lipid profile test is recommended. A
lipid profile test consists of the following: Total cholesterol,
High-density lipoprotein, as well as Low-density lipoprotein
(Lee & Siddiqui, 2021). These tests help in assessing
cholesterol and lipoprotein abnormalities caused by obesity.
Treatment
Marissa's situation does not warrant the use of influenza
medications like Oseltamivir or Zanamivir because they are
only suggested for use within 48 hours of the onset of the
symptoms (CDC, 2022). In this case, ibuprofen and
acetaminophen are recommended for pain and fever treatment,
respectively (Clinic Cleveland, n.d.). In addition, honey and
lemon might be taken by the patient (Jovinally, 2021).
According to several studies, coughs and sore throats may be
lessened and soothed with honey and lemon.
Patient education
Educating the patient on how to prevent virus transmission by
cleaning the hands, covering the nose when sneezing, and
remaining home from school until the symptoms have subsided
(CDC, 2022). Education on the dangers of secondhand smoke
exposure (CDC, 2022). Influenza and bronchitis could be
exacerbated by smoke (CDC, 2022). Exercises and balanced
diet: Marissa is obese because her body mass index (BMI) is
greater than the 95th percentile. An exercise plan is
recommended for kids with high cholesterol or low LDL
(Enkhmaa et al., 2018). In Marissa's case, her cholesterol was

4. 185mg/dl, which is beyond the normal range of 170 mg/dl
(Enkhmaa et al., 2018). Her LDL level (120mg/dl) was within
the normal range, so she did not require any medical treatment.
Referral
Referral to a dietitian. Some of the dishes in the school's dietary
pattern are unhealthy and could lead to obesity in other children
(Kim et al., 2019). As a result, she requires assistance managing
her weight and diet, as well as identifying any issues that may
arise. Obesity will be addressed in this way.
References
Arnold, J. C., & Nizet, V. (2018). Pharyngitis. In
Principles and Practice of Pediatric Infectious
Diseases (pp. 202-208.e2). Elsevier.
https://doi.org/10.1016/b978-0-323-40181-4.00027-x
CDC. (2019, November 12).
Rapid influenza diagnostic tests. Cdc.Gov.
https://www.cdc.gov/flu/professionals/diagnosis/clinician_guida
nce_ridt.htm
CDC. (2022).
Influenza antiviral medications: Summary for
clinicians. Centers for Disease Control and Prevention.
https://www.cdc.gov/flu/professionals/antivirals/summary-
clinicians.htm
Clinic Cleveland. (n.d.).
The common cold and the flu. Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/13756--colds-
and-flu-symptoms-treatment-prevention-when-to-call
Enkhmaa, B., Surampudi, P., Anuurad, E., & Berglund, L.
(2018).
Lifestyle changes: Effect of diet, exercise, functional

5. food, and obesity treatment on lipids and lipoproteins.
MDText.com. https://www.ncbi.nlm.nih.gov/books/NBK326737/
Jovinally, J. (2021, January 22).
11 Cold and Flu Home Remedies.
https://www.healthline.com/health/cold-flu/home-remedies
Kim, H. S., Park, J., Ma, Y., & Im, M. (2019). What are the
barriers at home and school to healthy eating?:
Overweight/obese child and parent perspectives:
Overweight/obese child and parent perspectives.
The Journal of Nursing Research: JNR,
27(5), e48.
https://doi.org/10.1097/jnr.0000000000000321
Lee, Y., & Siddiqui, W. J. (2021).
Cholesterol Levels. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK542294/