Abstract
A 35-year-old woman presented with a fever of 39.5°C and chief complaints of a headache and pharyngeal pain that made eating difficult. The oropharynx showed no signs of inflammation, but nasopharyngoscopy revealed pus throughout the nasopharynx. The patient's family history revealed that her one-year-old son had been treated for a respiratory syncytial virus (RSV) infection at our hospital seven days prior to her examination. A rapid diagnosis of a nasopharyngeal fluid swab was positive for RSV. A blood test revealed strong inflammatory reactions, with a leukocyte count of 16,000/μℓ (82.1% neutrophils) and a CRP level of 12.1 mg/dℓ. Pus from the nasopharynx tested positive (3+) for Moraxella catarrhalis. The patient was diagnosed with an RSV infection complicated by a severe bacterial infection of the nasopharynx. Outpatient intravenous (IV) antibacterial therapy was indicated, so 2 g/day intravenous ceftriaxone was administered for 3 days. The fever subsided after IV antibiotic therapy, and the patient recovered after receiving 400mg garenoxacin once per day for 5 days. This case underscores the importance of inquiring about family history when treating acute nasopharyngitis, and that an RSV infection should be considered when making a differential diagnosis.
