Otherwise healthy patient presenting with constellation of symptoms likely representing uncomplicated viral upper respiratory symptoms as characterized by mild pharyngitis

Unlikely PTA/RPA: no hot potato voice, no uvular deviation,
Unlikely Esophageal rupture: No history of dysphagia
Unlikely deep space infection/Ludwig’s
Low suspicion for CNS infection bacterial sinusitis, or pneumonia given exam and history.

Unlikely Strep or EBV as centor negative and with no pharyngeal exudate, posterior LAD, or splenomegaly.

Will attempt to alleviate symptoms conservatively; no overt indications at this time for antibiotics. No respiratory distress, otherwise relatively well appearing and nontoxic. Will discuss prompt follow up with PMD and strict return precautions.

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**Likely Low risk influenza infection: patient with myalgias, fever, and upper respiratory symptoms but is not under 5yrs old or over 65yrs old, not chronically ill or immunosuppressed, not pregnant or living in a nursing home. Droplet precautions in hospital. Pt within 48hrs of onset of symptoms; plan tx w Tamiflu (adults 75 mg BID x5D, children weight based). Home isolation is preferred for first 5 days adult, 10 days of illness children to prevent Droplet spread.

**Possible Pertussis: contact with other individual w prolonged cough, symptoms of URI (rhinorrhea, congestion, malaise, cough, sneezing) for about a week followed by prolonged paroxysmal sleep disturbing cough. As immunocompetent adult do not suspect secondary PNA. Chronic cough not likely 2/2 GERD, asthma, ACEI use, or atypical PNA. Plan Azithromycin 500 x1D then 250mg D2-5.

Unlikely SARS (coronavirus) given no travel to China, no diarrhea, no severe respiratory compromise, nontoxic appearance, and other dx more likely

Unlikely MERS (coronavirus) given no travel to Middle East, no diarrhea, no severe respiratory compromise, nontoxic appearance, and other dx more likely