Question

Viral URI Versus Bacterial



18-year-old female presents with congestion and cough for 3 days.

HPI: Onset 3 days ago. Begin with fatigue and low-grade fever, 99.8 at home with oral thermometer 2 days ago. Sore throat initially, but not now. Positive for nasal and head congestion, ears popping, but no pain or changes in hearing. Denies nausea, vomiting, or diarrhea. Reports less energy and disinterest in food. Denies any rashes. Has not tried anything for symptoms. Reports many sick students at school as well.

Second patient

28-year-old male presents with cold like symptoms that are worsening with fever and cough for 9 days.

HPI: Started out like regular cold then gradually worsened after 7 days. Very tired and winded. Productive cough increasing over last 4 days. Fever at home yesterday 100.9 and taking Ibuprofen once or twice a day for fever and malaise. Had sore throat, runny nose, congestion, and light cough in the beginning, but now only productive cough and fever. Tried Robitussin but it did very little. Productive cough all the time. Phlegm is yellowish green and thick. Cough does keep him up at night. Uncertain of other sick contacts. Although, he visited an uncle in the hospital 2 weeks ago where he had been diagnosed with pneumonia and COPD.

• Compare and contrast the presenting symptoms in these two patients.
• Describe, briefly, the differences and/or similarities in the pathophysiology of the condition of these patients.

Answer 1

In first patient, as per HPI itis a viral infection . And in second case, it is a bacterial infection. Bacteria and virus can both cause mild to serious infections, they are different from eachother. In both viral and bacterial infection, fever is common. In this cases, cough and fatigue are common. In first case, no sputum present, but in second case, yellowish green sputum ( phlegm) present, it is a sign of bacterial infection. In the case of viral infection, sputum will be in white colour. The first case symptoms started with fatigue, low grade fever and sore throat. These all are concluding that , this is a viral infection. And in second case, symptoms started with regular cold .

In first case, reports many sick students at school as well. But in second case, there is not. In the second case, patient have a history that, he visited uncle in the hospital 2 weeks ago, where he had been diagnosed with pneumonia and COPD. And HPI includes cold like symptoms worsening with fever and cough, very tired and winded , productive cough and phlegm. These all are concluding that , the patient have bacterial infection. Productive cough is a feature of bacterial infection.

So, we are concluding that, first patient suffering from viral infection and second patient from bacterial infection.

Thankyou