what do you guys think?

[HiddenTruth]

21y/o medical student, having recently started medicine rotation, has a 3 day h/o fever (100.5-101.5), malaise, soar throat, dysphagia, productive cough--yellowish in nature. Took tylenol for symtomatic relief. On 3rd day, c no improvement, initiated Azithromycin (very reluctant to start antibiotics without definitive diagnosis/culture). On 4th day:afebrile, no apparent disterss, no complaints of fatigue/malaise, cough improved, improvement in soar throat, however states "fullness when swallowing"/dysphagia. Also noticed unilateral multiple, round, white exudates in posterior oropharxynx, precisely on the buccal mucosa, inferior and lateral to the uvula.

What do you guys think. Strep pyogenes?? I freaked out when I saw those white "things". I didn't have my micro book c me, but I ran out to my car to get my robbins, and read the heck out of strep and EBV and some other things that can have similar presentation.

Disclaimer, my uncle is a doc, and has given my parents samples of few commonly used antibiotics. I didn't have penicillin =/. Should I just stick c the 5 day course and finish it? Or should I actually ask the attending for his consult? It's resolving, so....

On a side note--i hate the freaking hospital--gosh, i feel like im so much more tired at the end of the day, and not only that, im catching wierd thigns that i have never had in my life before. Thanks

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[Mossjoh]

Zithromax would cover Strep pyogenes

 

[NateatUC]

I had almost exactly what you describe when I was on Medicine. Only my fever was significantly higher (102-103.5). You didn't mention if you have any URI/sinus sx, but my money is definitely on strep, maybe with a touch of sinusits or bronchitis to account for the yellow sputum.

And I'm a fan of Zithromax for this. It'll cover strep and all the URI bugs, some of which straight PCN may not (unless you mean you have something like amox), and its easy to take.

 

[Tristero]

Take a Z-pack, that'll nuke most anything in your system that you'd be worried about.

 

[b&ierstiefel]

Finish the 5 day course. Hope you feel better.

 

[HiddenTruth]

thanks for the input.

It's gotten a lot better. Jus gonna finish the Zpak--and am gonna walk around wearing a mask

 

[Doc Ivy]

thanks for the input.

It's gotten a lot better. Jus gonna finish the Zpak--and am gonna walk around wearing a mask

Remember to wash your hands ---compulsively, this might keep you from catching so many random bugs on the wards

 

[JunkintheTrunk]

wow, a 21 y.o. ms-II(III?)....that's hot.

 

[FernandoV]

21y/o medical student, having recently started medicine rotation

How are you an M3 and 21??? Combined bachelor's/MD program? If so, where?