Question

Q3 Case study: Peter Smith, a 19 year old university student, was suffering from influenza and visited his local GP. He said he began to feel unwell two days earlier and his condition had worsened since with an acute onset of a sore throat(pharyngitis). On examination the following observations were made: Fever of 38.9 degrees C, Runny nose, Sneezing, Enlarged anterior cervical lymph nodes (lymphadenopathy) Peter’s throat was observed to have the following signs: Redness, Swollen, Having a patchy covering of yellow-white exudate over his tonsils The doctor prescribed phenoxymethylpenicillin 500 mg twice per day for ten days.

Question: Given that influenza is caused by a virus, why was Peter prescribed an antibiotic?

Answer 1

ANSWER: Peter, 19 year old, university student who was suffering from influenza had following signs and symptoms two days back:

1. Sore throat (Pharyngitis)

2. Runny nose

3. Sneezing

4. Fever (38.9°c)

5. Enlarged anterior cervical lymph nodes (Lymphadenopathy)

6. Red swollen tonisls with patchy covering of yellow-white exudate over his tonsils.

All of the above mentioned signs and symptoms are suggestive of a condition called Tonsillitis. Tonsillitis is an inflammation of tonsils due to bacterial or viral infection of throat.

Risk factor of tonsillitis is:

1. Young age- Tonsillitis due to bacteria is more common in young.

2. Frequent exposure to germs- school and university going students are at risk of tonsillitis due to close contact with friends and classmates which makes them vulnerable to viral and bacterial infections frequently.

• Most common bacteria causing tonsillitis is streptococcus pyogene.

• In general, after physical examination of throat, when doctor diagnosis tonsillitis, lab tests for throat swab are done to further check for whether tonsillitis is due to virus or bacteria. A sample from throat of secretions is taken and checked in lab for streptococcus pyogene. If the test is positive, then it is bacterial tonsillitis and if test comes negative then it is viral tonsillitis.

- Since, Doctor prescribed Peter an antibiotic phenoxymethylpenicillin, that means peter's throat swab test would have been positive for streptococcus pyogene and peter has bacterial tonsillitis and not viral tonsillitis, because the treatment of bacterial tonsillitis is a complete course of antibiotic, of class penicillin.

Moreover, the treatment of viral tonsillitis is not antibiotic penicillin. The treatment for viral tonsillitis is as follows:

1. Enough sleep.

2. Take adequate amount of warm liquids (like warm water with honey) to releive the sore throat and keep the throat moist.

3. Do Gargles, by adding 1 teaspoon of salt in a glass of warm water, to relieve sore throat.

4. Use lozenges to soothe sore throat.

5. Take antipyretic for fever and analgesic for pain.

6. Take food that is soft and smooth in consistency