Patient Cathy
Further questions I would have for Cathy during this visit are the following: Are you coughing phlegm (greenish in color)? Do you have a fever or feel ill or have a headache? Have you taken any long flights recently? Have you been feeling anxious about anything lately? Have you had any stiffness in your neck? Have you experienced a loss of appetite? Felt confused? Have you suffered from any seizures? Can you touch your chin to your chest? Do you drink alcohol? Do your ears feel full?
Because the patient has been using her inhaler when exercising, it is not likely that she would feel any pain in her chest because this is meant to prevent it; however, other signs are evident that she may have an infection and it is important to examine her body systems more closely.
The differential diagnosis list for this visit thus far would be that the patient's cold has developed into a sinus infection. Patient is likely suffering from sinusitis, an infection of the sinuses. Her spring cold has led to this infection, as it has lingered for two weeks and now it has gotten into her lungs, which explains her lack of energy and her inability to breathe normally. If not treated, it could develop into bacterial meningitis, whic attacks the meninges that shroud...
It is a potentially deadly infection and one that can be contagious as well. It is caused by a bacterial infection that can start in the sinuses and make its way to the brain through the bloodstream.
There are different bacteria strains that could be at work in the patient, from pneumococcus (the most common cause in both young children and adults in the U.S., and which usually begins as pneumonia or ear/sinus infection) to meningococcus, which starts as a respiratory infection. Roughly 4000 cases of bacterial meningitis are reported per year (Thigpen et al., 2011), thus it is not something to be taken lightly, as it can lead to death.
The symptoms of bacterial meningitis are high fever, headache, stiffness in the neck that prevents the patient from lowering the chin to the chest, confusion, seizures, and loss of appetite. Symptoms occur rapidly within one day of the onset of infection. This is the reason for asking the questions above regarding the differential diagnosis. Because it can occur quickly, the answers to the questions can indicate if the patient is at this stage or not.
I would focus on the lungs to hear if how heavy the breathing is and to see if it is congested. Based on the symptoms, it is likely…
