Infectious Disease
Case 27: A Young Man with a Sore Throat
CASE
A 30‐year‐old man presented to hospital with a 7‐day history of sore throat, fever and malaise. He had been previously fit and well. There was no history of recent travel. On examination he looked unwell. He was sweaty and had warm peripheries. He had a temperature of 39°C, arterial blood pressure of 90/60 mmHg and a heart rate 115 beats/min. His respiratory rate was 22 breaths/min with an oxygen saturation of 97% on air. Examination of his chest and abdomen was unremarkable and he had normal heart sounds. He also had swollen inflamed tonsils with purulent exudates.
You arrange for some investigation and the results are as follows:
Hb 15 g/dL WCC 18 × 109/L (80% neutrophils) Platelets 240 × 109/L CRP 170 mg/L ESR 60 mm/h Na 142 mmol/L K 3.5 mmol/L Urea 6 mmol/L Creatinine 110 µmol/L
Throat swab: Gram‐positive cocci
Blood film: Gram‐positive cocci
MSU: normal
Chest X‐ray: normal
QUESTION 1
Your score this session: 0 of 0
Which diagnosis best fits this clinical scenario?