An evaluation of the symptoms reported by the patients suggests the presence of inflammation in the nasopharynx area, which causes swallowing pain. Moreover, the absence of cough and respiratory complications provides the basis for the provisional diagnosis, which is tonsillitis. Other symptoms relevant to this disease can be found during the further examination of the patient’s physical condition. They include increased body temperature, the presence of exudate on the tonsils, and swollen lymph nodes on the left side. As the patient can breathe and swallow normally and does not have respiratory symptoms, tonsillitis is a primary diagnosis that should be further approved.
During the differential diagnosis, such conditions as scarlet fever, common cold, and Pfeiffer’s disease (infectious mononucleosis), characterized by a sore throat and high temperature, were excluded. As Di Muzio et al. (2016) claim, tonsillar exudate and swelling on the tonsils speak of the bacterial nature of the illness and eliminate the possibility of a common cold. The patient does not have a skin rash or ‘strawberry tongue, generally observed during scarlet fever, thus, this diagnosis does not have sufficient symptoms. Although the symptoms of bacterial tonsillitis and infectious mononucleosis are similar, the latter is caused by the virus. Therefore, lab tests that speak of a bacterial infection can help distinguish this condition from mononucleosis.
As the nasopharynx can contain hundreds of kinds of bacteria, it is often difficult to identify, which one has caused the disease. That is why WBC differential can be informative in providing the signs of immune reaction and proving that the infection was caused by bacteria and not a virus. According to Nakao et al. (2018), band neutrophil ratio and WBC count are significantly higher among the patients with bacterial tonsillitis than in the control group. In the case of this patient, similar parameters are observed, which proves that his immune system is managing a bacterial infection. Therefore, the diagnosis for the discussed case study is tonsillitis of bacterial origin that requires relevant treatment.
References
Di Muzio, F., Barucco, M. & Guerriero, F. (2016). Diagnosis and treatment of acute pharyngitis/tonsillitis: a preliminary observational study in General Medicine. European Review for Medical and Pharmacological Sciences, 20, 4950-4954.
Nakao, Y., Tanigawa, T., Kano, F., Tanaka, H., Katahira, N., Ogawa, T., Murotani, K., Nagata, T. & Shibata, R. (2018). Diagnostic role of mean platelet volume in tonsillitis with and without peritonsillar abscess. The Journal of Laryngology & Otology, 132(7), 615-618.