Updated 23 July 2015

What's your diagnosis? - Case 13: severe sore throat

Should you be concerned if your throat becomes so sore that you can’t even swallow a sip of water? In our mystery case this week, we meet Ms X who presents to her GP with a painful throat. Grab your tongue depressors and help solve our case in this week’s “What’s your diagnosis?”


Ms X, a 31-year-old nursing assistant, can’t recall the last time she had the flu and initially thought her sore throat could just be a transient problem as she had no other flu-like symptoms or fever.

The next day, however, it started getting more and more painful, especially on the right-hand side. She felt feverish and her right ear was also very painful. She went to her local pharmacy and bought over the counter throat lozenges and mouth wash.

After a night of no sleep, experiencing severe pain in her throat and ear, she decided to visit her GP.

The following is a summary of his notes:


Week history of sore throat:

·         Initially generalised, now most painful on the right hand side

·         Associated with fever and a painful right ear

·         Unable to swallow properly

·         Reports no difficulty breathing. Complaining that her jaw is “tight”.

·         No medical or surgical history

No allergies
No current medication use
Non-smoker and rarely uses alcohol


Patient appears to be in pain. Speaks softly. Some saliva noticed at mouth corners.

Systemic examination: no abnormalities found

Throat: very red, swollen mass on right side of throat, in the area of tonsillar bed. Uvula appears to be pushed to the left side of throat. Airway still open.

Patient finds it very difficult to open her mouth.

Side Room

Temperature: 38.9° C
Urine clear 

Based on the information above, what do you think is the most likely diagnosis?

What’s your diagnosis? Join the guesswork on our Facebook page, or comment below. 

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays. We'll post the answer with the story on Mondays, or you can get it via the Daily Tip – sign up here.

Previously on What's Your Diagnosis

What's your diagnosis? -  Case 1: vomiting and weight loss
What's your diagnosis? -  Case 2: eye pain
What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back
What's your diagnosis? -  Case 4: seeing odd things
What's your diagnosis? - Case 5: mysterious lungs
What's your diagnosis? - Case 6: runner with seizures
What's your diagnosis? - Case 7: swollen knee
What's your diagnosis? - Case 8: bloody semen
What's your diagnosis? - Case 9: confusing neurological signs
What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms
What's your diagnosis? - Case 11: bruising with no apparent reason
What's your diagnosis? - Case 12: severe tummy pain

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


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