CASE 43 - Sore Throat

Question 1

Do you think I have AIDS?

Answer 1

What makes you think you might have AIDS? Do you believe that you have been exposed to HIV?

It is a possibility, but I will not be able to tell until I have ordered some blood tests.

Question 2

Specific Qs:

Answer 2

None specific.

Question 3

PEx:

Answer 3

1. Head and neck exam ==> Examined nose, mouth, throat, lymph nodes — checked for sinus tenderness.
2. CV ==> A.
3. Chest ==> A.
4. Abdo ==> A + P + P.
5. Skin/lymph node exam ==> Inspected for rashes, lesions, lymphadenopathy.

Question 4

DDx:

Answer 4

1. IM.
2. Acute HIV infection.
3. Streptococcal pharyngitis.
4. CMV infection.
5. Other infectious etiologies.

Question 5

Workup:

Answer 5

1. CBC with peripheral smear.
2. Monospot test.
3. Anti-EBV abs.
4. HIV antibody and viral load.
5. Throat culture.
6. Rapid streptococcal antigen.
7. CMV antibody titers/CMV PCR.