A 5-year old white male child in good general health and physical condition was presented at the Saturday walk-in clinic by his mother. He was brought in because he had a fever was cranky and had complained of a sore throat for about 24 hours. On physical examination by the attending resident the patient had a fever of 103oF. He had considerable swelling and drainage of the pharynx and in the conjunctivae. His tonsils were enlarged and coated with a white patchy exudate. He had a red throat and swollen anterior cervical lymph nodes. His ears were clear. His chest sounded clear and he had no additional remarkable findings on routine examination. A rapid Strep test run ASAP by the lab was positive. Bacteria grown from a throat swab taken at the time of examination indicated gram positive Beta hemolytic bacteria. 1. What would be your presumptive diagnosis for this child? Why? 2. What diagnostic testing would be indicated to follow this exam? 3. What is the most likely treatment for this illness? Why is it important? 4. What factors of this case allowed you to make a presumptive diagnosis? 5. What serious consequences can result if treatment for this infectious agent had not occurred in a timely manner? 6. What bacterial virulence factors are associated with this condition? 7. Might this child experience the same infection again? why and why not? Show less
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