Friday, September 28, 2007

Mom Wants Antibiotics

A mother brings her 14 year old boy into the clinic because he's been complaining of a fever, sore throat, and headache. He also has pain when chewing; he hasn't been eating much. He says it hurts when he drinks apple juice or orange juice. On exam, you see this at his right neck:

As a well-trained medical student, you ask the mother to step outside while you ask the boy about sex, drugs, and rock-and-roll. He whispers, "Well, there is this one balls really hurt." You see that he has a swollen left testicle and swollen inguinal lymph nodes on the left side.

Challenge: What is the causative agent of this disease?

Related Questions:
1. What is seen in the image?
2. What is the testicular finding called?

Image shown under fair use.


emily hw said...

yersenia pestis or tularemia
cervical bubo
no sure about testicular finding

Craig said...

Mom Wants Antibiotics

The image shows swelling of the parotid gland (parotitis). Inflammation and painful swelling of the testicles is called orchitis. It should be differentiated from testicular torsion. These two signs/symptoms along with fever, headache, and sore throat can make the clinical diagnosis of mumps. Acidic foods and juices can cause pain. Mumps is caused by a paramyxovirus and spread by saliva droplets. The MMR(V) vaccine has significantly decreased the incidence of mumps in the U.S. Treatment is supportive.

Sources: Wikipedia, Encyclopedia Britannica

emily hw said...

that picture was pretty similar to ones of swollen lymph nodes in which it could be many things...but I guess the testicular finding is what would lead you to think of mumps??

Alex said...

oh man, i was about to say mumps and the picture didn't really click for me. Just had GU clinical skills today and we talked about mumps + orchitis.