Cause 1 10 years girl suddenly has high fever 39,2 C and a sore throat Cause 1 10 years girl suddenly has high fever 39,2 C and a sore throat. She change the timbre of the voice and refuse food. She hasnt cough.

Phisical examination * large red, swollen and inflamed tonsils with exudates * painful cervical lymmphadenopathy

Cause 2 30 years men with blocked up nose has sore throat, mild headache, sneezing ,burning eyes and a nonproductive cough. The fever is low –grade , less 38 C.

Phisical examination. oedematosus and erythematosus pharyngeal mucosae Phisical examination * oedematosus and erythematosus pharyngeal mucosae * clear nasal dicharge *lack of cervical liphadenopathy

Cause 3 17 years schoolboy has severe sore throat with mild headache and malaise. He has feel unwell since one week.He has also a widespread maculo papular rush after amoxicillin

In phisical examination. marked tonsillar swelling and exudates In phisical examination * marked tonsillar swelling and exudates * widespread lymphadenopathy * enlarged spleen

What is the diagnosis in this 3 cases?

1 – tonsillitis-bacterial infection causes by A beta-heamolytic streptococci 2 – viral rhinosinusitis (common cold) 3 – infectious mononucleosis

Cervical lymphadenopathy Centor criteria: Three or morefeatures inccreases the likelihood that strep A is the cause of the infection Fever>38 C Lack of cough Tonsillar exudates Cervical lymphadenopathy

Treatment – bacterial tonsillitis Treatment – bacterial tonsillitis * drug therapy: antibiotics first choise is pencillin V at a dose of 25-50 mg/kg/day or amoxicillin at a dose 50 mg/kg/day for 7-10 days (duration of treatment is debated) second choise is amoxicillin with clavulanic acid or clindamicin allergy to pencillin macrolids like: clarithromycin,azithromycin, spiramycin

Treatment of viral infection Treatment of viral infection * The commmon cold is a self limiting disease * Treatment is symptomatic. Receent systematic reviews have demonstrated that there is no benefit from the administration of antibiotics to patients with VRs * Treatment of nasal obstruction and rhinorrea: antiadrenergic drugs like pseudoephedrine and antihistamines non sedating newer like cetirizin *Analgesic-antipyretics: paracetamol or ibuprofen * Over-the-counter medications(OTC)

Treatment of mononucleosis Treatment of mononucleosis * Mononucleosis is also a self limiting disease * Treatment is symptomatic. Some major complications should be managed in the hospital setting *

Sore throat Sore throats are commmon in family medicine Sore throat Sore throats are commmon in family medicine. The majority of sore throats are caused by viral infections ( over 200 viruses have been implicated)