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Fever and Sore Throat
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You are completing your Pediatrics rotation and are working in the pediatric emergency department for the night. At 4:00 PM, your preceptor asks you to see Austin, a 3 year old male who has presented with a fever and sore throat. As you enter the room you notice that Austin is awake and alert, and being held by his father. His father indicates to you that Austin was active last evening and this morning, however he began to decrease the amount of playing he normally does this afternoon. His sore throat began approximately 45 minutes ago, and concerned his father as he was crying due to the pain. Austin’s father also noticed that he felt warm at that time, and measured a temperature of 38.1°C. Which of the following options should be obtained on history?
Responses:
choose any, all or none
Explanation:
Austin presents with a very vague history, and as such the potential causes of his fever and sore throat is quite vast. The more information that is provided about Austin, the greater the ability to correctly identify the underlying cause of his fever and sore throat.
Information such as travel history, sick contacts, preceding prodrome, length of time that fever has been present and immunizations all provide information as to whether Austin may have an infection causing his symptoms. If Austin has not been immunized, he is at an increased risk of picking up certain infections that other children are immune to. Similarly, if Austin has traveled recently, there is an increased risk of acquiring an infection not commonly encountered in the area that he currently lives.
Questions related to weight loss, changes in bowel habits and changes in eating habits all provide information regarding the acuity of Austin’s presentation. If enough time has elapsed to cause weight loss, the presenting complaint may be more of a chronic problem than originally though. Additionally, changes in eating habits and bowel habits provide information about Austin’s health before this presentation, as well as information about his hydration status.
Previous illnesses and the gestational and delivery history provide clues as to whether Austin may have an underlying disorder, such as being immunocompromised. Although many children do get frequent colds, it is relatively uncommon for children to be admitted to hospital numerous times.
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