What could be another differentialdiagnosis for this case
Pleaseuse mycoplasma pneumonia for differential diagnosis
Includes/sx / how to diagnoses (diagnostic testing
Room 2: 8-year-old Rhiannon Regis is broughtto the clinic by her mother Rachel Regis for cough, which began 3 days ago.Mother reported that cough worsens at night, especiallywhen laying flat. The mother reports that the child has been exposedto other children who had been coughing when they went to see her parentsduring the weekend. Mother reported that last night, patient reported fever, malaise, body aches and productive sputum, thick greenish yellow innature.
Allergies: NKDA. No drug, food, environmental, seasonal or latex allergies
Vital Signs: T: 100.7 P 97 R 16 BP 112/80 SpO292%
Chest: Symmetric expansion. No use of accessory muscles, Respiratory Rate: 26,Swollen lymph node upon palpitation
Lung sound- wheezing and fine cracklesnoted to left lower lobe
In thisscenario, the patients chief complaint was cough that began three days ago.Cough is a common symptom that many adults and children complain of whenseeking medical care. According to Kasi & Kamerman-Kretzmer (2019), coughcan be caused by a range of minor respiratory diseases such as a common cold tomore serious infections such as bronchiectasis and pneumonia, requiring moreprompt treatment. As a provider, utilizing a systematic approach can bebeneficial in helping achieve the correct differential diagnosis for thepatient. Obtaining a detailed history and physical examination is crucial forevaluations of a child complaining of a cough (Alsubaie et al., 2015).According to Bickley (2021), when patients complain of cough, a thoroughassessment should be established including determining when the cough started,duration, alleviating and aggravating factors. An adequate history and physicalshould be obtained, especially regarding possible triggers, associatedsymptoms, environmental exposures and irritants, medications and allergyhistory (Alsubaie et al., 2015). Bickley (2021) also noted the importance ofnoting if the cough is dry or productive, and if productive, color, odor, andconsistency. Asking the patient if there is chest pain or chest discomfort,difficulty taking deep breaths, and noting if there is presence of increasedwork of breathing or abnormal breath sounds can help point the provider to theright diagnosis.
In thispatient case, the patient developed a cough that developed 3 days ago and notedworsening when laying supine. Key points in this case includes Spo2 of 92%,fever, malaise, tachypnea and swollen lymph nodes which can signify infectionand inflammation. Productive sputum that is thick yellowish green and finecrackles in left lower lobe can signify infection in the lungs such aspneumonia so imagining may be needed to obtain a more definitive diagnosis.
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