In this patient’s case, the symptoms that will help determine the primary and differential diagnoses are sore throat and issues, and pain when swallowing. Tonsillitis is the diagnosis for the patient in the discussed case study, which was determined through the evaluation of symptoms and by reviewing the lab results. This paper will determine the provisional primary and differential diagnosis and discuss why the infection is bacterial based on lab results.
Firstly, the provisional diagnosis is based on the following symptoms – sore throat and no coughing for the last twenty-four hours. The most common cause resulting in similar symptoms is an infection (Windfuhr et al., 2016). Next, further evaluation of the patient reveals a temperature of 38 degrees and tender enlarged anterior cervical lymph nodes. These symptoms are consistent with tonsillitis. The main symptoms include swollen lymph nodes, sore throat, and difficulty when swallowing ( Windfuhr et al., 2016). The results of lab testing can help in the subsequent evaluation of this diagnosis.
Next, the lab results further support the initial and differential diagnoses. Mainly, the high neutrophils suggest that this patient has an infection, and in most cases, it is caused by bacteria (“Understanding neutrophils, n.d.). Neutrophils are the white blood cells that indicate that the immune system of this patient is responding to a threat. Hence, the increased levels of neutrophils are an indication of a bacterial infection. In addition, the patient’s white blood cells (WBC) count is also high, which points out to an infection. Hence, the lab results help establish that this patient is suffering from a bacterial infection. Overall, this case study reveals a patient who experienced a sore throat and has trouble swallowing. The primary diagnosis is an infectious disease. Upon further investigation, the differential diagnosis of tonsilitis.
Windfuhr, J. P., Toepfner, N., Steffen, G., Waldfahrer, F., & Berner, R. (2016). Clinical practice guideline: Tonsillitis I. Diagnostics and nonsurgical management. European Archives of Oto-Rhino-Laryngology, 273(4), 973–987.