Pediatrics: Common HEENT Disorders & Symptoms for Diagnosis - Essay Sample

Introduction

Pediatrics is a branch of medical science that deals with the medical care of children, adolescents, and adults. Most of the head, ear, nose, and throat (HEENT) infections account for most of the pediatric visits. These disorders can be associated with multiple symptoms and make it difficult to diagnose. One should be familiar with these signs and symptoms to avoid the wrong prescription, which may be dangerous or lead to some dangerous allergic reactions. At this point, it requires specialist care. Some common forms of HEENT disorders are ear infections, allergies, eye infections inflammation, and infections in the nasal cavity.

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For case study 3, Marcus an 8-year-old has 36-hour complaint of headache (frontal). Sore throat, fever that goes up to 102 , and Nausea. He also has decreased appetite, and his breath smells "like a puppy dogs." For this disorder, due to the reduced appetite and the smell from the breath indicates that there is an infection around the nasal cavity.

Doing a physical inspection of the patient will include; a detailed history from the start of the symptoms to know if there is a possibility of a history of seasonal symptoms, association of the patient with allergies, environment around the patient, and any medications used to treat existing symptoms if any. Also, a careful check of the HEENT system for any disorders, which will help rule out some of the anatomic malformations. It also helps in getting clues based on additional assessment and diagnostics needed, ask the common signs and symptoms which includes; cough, nasal drainage, throat irritation, ear pressure or pain, difficulty swallowing, chills or fever, bad taste in the mouth, nausea, and vomiting.

From the symptoms provided in the case study shows that the patient has sinusitis whose symptoms would include; severe symptoms of fever up to 102 , and nasal discharge and facial pain lasting 3-4 days at the beginning of the illness, just like the symptoms in the above case. The mother of the boy says that the appetite has been decreasing and the onset of sinusitis would include the onset of worsening symptoms from an initial illness, then after a few days having headaches, fever and increased nasal discharge, which leads to a state referred to as double sickening. For this clinical diagnosis, it is recommended that antibiotics be given to the patient to ease these symptoms.

Routine lab and imaging studies are also essential for acute rhino sinusitis (ABRS); routine labs are not generally performed. However, if indicated, the following labs are helpful. The first lab test that might be helpful is the Complete Blood Count (CBC), this is mainly to determine the allergic reactions if any. Allergic causes of ongoing symptoms would appear as increased oenophiles which eventually causes an increase in the neutrophils. Imaging studies checkup may include any of the categories from plain sinus radiographs, CT scans, MRI or Fiber optic nasal endoscopy. Plain sinus radiographs are used to examine the paranasal sinuses and are cheap relative to the other imaging techniques. Air fluid level and mucosal thickening can be checked; it not a recommended imaging technique. CT scan is the most used imaging method used to study sinusitis. CT is much more detailed than the plain sinus radiographs, one other advantage of the CT is that it can show the surrounding tissues around the brain.

The working diagnosis of the symptoms in the above case is acute bacterial sinusitis. Sinusitis is characterized by inflammation, edema, and infection. The treatment of sinusitis is broken down to different methods in levels of its acuteness. It is subdivided into; acute, subacute chronic, and recurrent.

For the treatment plan, analgesic is needed and an antibiotic; amoxicillin is used as the first treatment, which goes 5-14 days depending on the occurrence and how severe it is, this is used to reduce pain. Patients allergic to penicillin can use respiratory fluoroquinolones (Kuhn,2003). Intranasal and systemic corticosteroids can also be used as a pharmacologic to offer the remedies to the sinusitis. Some other treatment methods available is the use of non-pharmacological methods; they include; saline nasal drops, sprays or irrigations, heated mist, increased fluid intake and ensuring staying in a well-moisturized environment.

Other ways of avoiding activation of sinusitis are avoiding the common causes of sinusitis, among them are avoiding allergens, swimming during cold phases, avoiding antihistamines, smoking, taking a lot of fluids and humidifying the air. If symptom persists after 24 hours, the child should be taken to see a doctor, and it could be worse. In case of any swelling in the periorbital area, it is advisable to see a doctor.

References

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Kuhn, F. A., & Swain Jr, R. (2003). Allergic fungal sinusitis: diagnosis and treatment. Current opinion in otolaryngology & head and neck surgery, 11(1), 1-5. Retrieved from (https://journals.lww.com/cootolaryngology/Abstract/2003/02000/Allergic_fungal_sinusitis__diagnosis_and_treatment.1.aspx)

Ponikau, J. U., Sherris, D. A., Kern, E. B., Homburger, H. A., Frigas, E., Gaffey, T. A., & Roberts, G. D. (1999, September). The diagnosis and incidence of allergic fungal sinusitis. In Mayo Clinic Proceedings (Vol. 74, No. 9, pp. 877-884). Elsevier. Retrieved from (https://www.sciencedirect.com/science/article/abs/pii/S0025619611648088)