help case study

rex rrreyes at enterprise.net
Sat Oct 12 10:46:19 EST 1996

A 2-year old male child experienced an upper respiratory tract
infection two weeks prior to hospital admission.  Four days prior to
admission, anorexia and lethargy were noted.  Patient was seen at the
accident and emergency centre of his local hospital three days prior
to admission.  At that time he had a fever of 39.9°C.  Physical
examination revealed a clear chest, exudative pharyngitis, and
enlarged cervical lymph nodes.  Throat culture was taken, and a course
of penicillin was begun.  The child state worsened, and he became
increasingly lethargic, he developed a respiratory distress on the day
of admission to hospital.  It was noted that the throat culture from
three days prior to admission had not grown any group A Streptococci.
Further examination, the patients temperature was 38.9°C and had an
exudate in the posterior pharynx that was described as a yellowish
thick membrane which bled when scraped and removed.  The patients
medical history revealed that he had received no immunisations.

What could be the causative agent for this disease?  please send your
reply to rrreyes at enterprise.net thanks...

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