Your next patient is a 17 year-old Bret who comes in complaining of a “bad cold” for five days. He was managing okay with Dayquil but yesterday he started having copious tan colored nasal discharge and tooth pain on the right side. He also started having an uncontrollable cough and chest tightness with some wheezing at soccer practice and had to sit out for the scrimmage. He is otherwise healthy, takes no other medication, and is allergic to penicillin. No recent antibiotics but did have a cold three weeks ago.
PMH: otitis media, childhood asthma.
- What subjective data do you need to evaluate the sinus symptoms?
- What subjective data do you need to address the cough symptoms?
- What are the most likely differential diagnoses for nasal congestion?
- What are five differential diagnosis for cough?
- You decide on a diagnosis of acute bacterial sinusitis. What features of the history and physical exam support a diagnosis of acute bacterial sinusitis?
- What are the most common offending organisms for bacterial sinusitis?
- Develop a treatment plan for sinusitis and incorporating all aspects of the rubric.
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