Case of the Strep

Last night I knew my cousin Lynne wasn`t feeling too well after finishing work. She came home, throat killing her. She passed out, and I went to school the next morning to do my OSCE – an evaluation.

I had been practising my clinical skills all week with my friends. History taking and a focused cardiac, resp, abdominal and MSK exam. After completing the two hour OSCE, I drove immediately home. Found Lynne passed out looking feverish, her arms splayed, not being able to open her eyes.

Having done an entire OSCE this morning, I grabbed my stethoscope, and a light. I sat her down asked a few questions. So my history:

“20 year old female presents with sore throat. Onset of soreness began approximately yesterday. She describes no cough, no rhinorrhea or other coryza symptoms. No ear pain. A slight headache. She has fever and chills, as well as generalized weakness.”

Listened to her chest, palpated her cervical lymph nodes, which a few were tender. Look inside her throat, and bingo.

“Strep throat, you have strep throat.”

Also known as bacterial pharyngitis, or streptococcal pharyngitis. Here’s what I saw at the back of her throat:

A normal vs. strep throat. Notice the white exudates at the back, a key feature of strep.

I immediately took her to the doctor, who gave her some antibiotics, a 10 day course of Penicillin V. I suspected the symptoms were too severe for “just the flu”. Of course I had seen dozens of strep throat during my family medicine rotation.

I took her to Tim Hortons where she had some soup and hot chocolate (no milk). Now some R & R.