INTERNAL MEDICINE CASE STUDY
A 26-year-old teacher has
consulted her clinician for her persistent cough. She wants to have a second
course of antibiotics because an initial course of amoxicillin made no
difference. The cough has troubled her for 3 months since she moved to a new
school. The cough is now disturbing her sleep and making her tired during the
day.
She teaches games, and the cough is troublesome when going out to the
playground and on jogging. In her medical history she had her appendix removed
3 years ago. She had her tonsils removed as a child and was said to have
recurrent episodes of bronchitis between the ages of 3 and 6 years. She has
never smoked and takes no medication other than an oral contraceptive. Her
parents are alive and well and she has two brothers, one of whom has hayfever.
Examination
The
respiratory rate is 18/min. Her chest is clear and there are no abnormalities
in the nose, pharynx, cardiovascular, respiratory or nervous systems.
A) What is the likely diagnosis?
Rheumatic heart disease caused by recurrent infection of Tonsilitis/bronchitis at the age of 3-6yrs, By Streptococci, which causes vegitation on the heart valves over a long period of time and makes the heart valves incompetent.
ReplyDeleteI thought RHD present before 21yrs. Kindly enlighten me on this
Deletethanks
ReplyDelete