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Jennifer experienced fever and palpable cervical nodes. This means she could have an infection as a result her tonsils. The infection could have led to lymphadenopathy. Since most patients that contract lymphadenopathy experience localized lymphadenopathy, Jennifer most likely has localized lymphadenopathy. "Distinguishing between localized and generalized lymphadenopathy is important in formulating a differential diagnosis. In primary care patients with unexplained lymphadenopathy, approximately three fourths of patients will present with localized lymphadenopathy and one fourth with generalized lymphadenopathy" (Ferrer, 2015, p. 1).
Palpable nodes are often swollen nodes that can be a result of an infection. Because her fever climbed over time and stayed relatively high, Jennifer may be experiencing acute infection since her patient history revealed no signs of previous disease. Causes for lymphadenopathy are often obvious.
"The cause of lymphadenopathy is often obvious: for example, the child who presents with a sore throat, tender cervical nodes and a positive rapid strep test, or the patient who presents with an infection of the hand and axillary lymphadenopathy" (Ferrer, 2015, p. 1). Tenderness on the left side also shows something possibly wrong from the side of the esophagus. The thoracic duct lies on the left side.
GERD or Gastroesophageal reflux disease may be responsible for the infection Jennifer experienced...
Stomach contents leaking back into the person's esophagus could cause damage to the lining of one's esophagus due to the strong stomach acids coming up with the stomach contents. Although the child is only two and has no serious history of anything that would cause GERD like obesity or hiatal hernia, the child exhibited the feeling of a sore throat, which is a less common symptom.
Scenario 2
Patient Jack reported no serious health concerns besides a rash on his hands. He explained he is otherwise healthy and only used chemicals without gloves a couple of times. His wife suggested allergies. Hand eczema or hand rash / hand dermatitis have many known causes. Dry hands may end up red and flaky, even inflamed. Being exposed to too much water, dry air, detergents, cleaning agents, rubber gloves, even detergents can cause hand rash. Skin sensitivity may be inherited and it may be important to see if Jack has ever had a history of hay fever or asthma.
The multiple ear infections he explained before do not appear connected to his current health problem. If it is irritation like overexposure to anything, the doctor will treat it differently than if it is caused by allergies. Even though hand rashes are not contagious, they can lead to infection if left untreated. Medicated ointments and antibiotics are often the first line of treatment. Things to look for in Jack's scenario would…
References
Calhoun, D., Jones, D., Textor, S., Goff, D., Murphy, T., & Toto, R. et al. (2008). Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation,117(25), e510-e526. doi:10.1161/circulationaha.108.189141
Ferrer, R. (2015). Lymphadenopathy: Differential Diagnosis and Evaluation - American Family Physician. Aafp.org. Retrieved 13 June 2015, from http://www.aafp.org/afp/1998/1015/p1313.html lni,. (2015). Clothing Dermatitis and Clothing-Related Skin Conditions. Retrieved 14 June 2015, from http://www.lni.wa.gov/sharp/derm
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