Patient: 3 year old child presenting with a 4 day history of fevers. He became a
ID: 144190 • Letter: P
Question
Patient: 3 year old child presenting with a 4 day history of fevers. He became acutely ill and vomited during lunch (not from bad food). Over the next 4 days, he developed fevers as high as 104" F that were controlled by Tylenol. He also developed cough, rhinorrhea and conjunctivitis. He appeared to be fatigued and parents reported that he was "very sleepy". Over the past 2 days his eyes had begun to itch and were painful. His parents noted that his eyes were puffy and he was sensitive to light. He had had no rashes. The child's lips were dried and cracked and greatly reduced urinary output. He had attended preschool twice per week where there were multiple sick contacts. His illness occurred in late January. His 1 year old sibling had otitis media, some wheezing, vomiting and a productive cough. A. Laboratory findings were normal. A nasopharyngeal swab was collected and tested for (select the one most likely test(s) to be done....emember, this is a virology course®): 1. Bordetella pertussis 2. Influenza A & B 3. RSV 4. Rhinovirus 5. 2 & 3 6. 1 &4 B. What do think the results of the test(s) were (Positive for which, if any)? C. His symptoms were consistent with which illness D. What is the typical outcome of this infection? E. How do think the patient became infected?Explanation / Answer
A. RSV- respiratory syncytial virus. It is most likely to perfom the test for RSV because the symptoms are similar to the symptoms shown by an RSV affected individual. This infection is common in children, especially when they are in contact with children who are infected.
B. The result for RSV will be positive.
C. His symptoms are consistent with RSV. Fever, cough, poor feeding and vomiting, mild to moderate nasal congestion with clear rhinorrhea, conjuctivitis are some of the symptoms of RSV.
D. The typical outcomes of RSV are pneumonia, bronchiolitis, otitis media, asthma, chronic heart and lung disease.
E. The patient got infected by the one year old sibling who showed typical outcomes and symptoms of RSV.