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Case 12

Gina brings Geraldine in to your office. Geraldine had a runny nose and nasal congestion a couple of days ago. Last night her mother mentions she had gotten worse. Geraldine woke up in the middle of the night with an awful cough and with difficulty breathing. Gina also mentioned that Geraldine's voice sounded funny. So you would hear the cough and her breathing she recorded Geraldine (click on links to hear sounds; breathing and cough). Geraldine's vital signs temperature; 101 degrees F, heart rate; 120/min, respirations; 23/min, and bp; 110/70. Examination revealed conjunctivitis, coryza, phyaryngitis and dyspnea on inspiration. Expiratory wheezes were noted on auscultation of the chest. No abnormal heart sounds were noted. The patient's cough was nonproductive. The patient was sent to the radiology department for tests.

Radiograph of head and neck
Radiograph of Chest


A. Using the patient's signs and symptoms and laboratory findings which of the following is the most appropriate diagnosis?

1. Acute bronchitis

2. Croup

3. Epiglottitis

4. Interstitial pneumonia

5. Laryngitis

6. Typical pneumonia

B. Which of the following likely cause of this patient's current condition?

    1. Staphylococcus aureus
    2. Haemophilus influenzae
    3. Influenza virus
    4. Adenovirus
    5. Parainfluenza virus

Click here for answer (look for * by correct answer)

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Site Last Revised 12/21/13
Neal Chamberlain, PhD. A. T. Still University of Health Sciences/Kirksville College of Osteopathic Medicine.

Take Care and Think Microbiologically!