Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-04-16 Encounter: Spruce text message followed by in-person home visit (NP Catherine Watson conducted home visit for strep test) CC: Fever and stomach ache after coming home from school, with concern for strep throat. HPI: Henry, age unknown, presented with fever and stomach ache after coming home from school the day prior (2026-04-15). Per his mother, he never complains of throat pain with strep but typically presents with stomach ache instead, consistent with prior strep episodes. By the evening of 2026-04-16, his temperature rose to 103.5°F with associated fatigue and headache; he was tolerating oral intake (breakfast, popsicle, sips of water). Mother reported minimal neck pain but no rigidity and normal head/neck range of motion. Motrin had been given at home while awaiting Tylenol. Assessment: Presentation concerning for strep throat given history of fever, stomach ache, and prior strep episodes with similar pattern. Evening follow-up reassessing fever to 103.5°F with headache; neck pain was minimal with no rigidity and normal range of motion, making meningeal irritation unlikely. Clinical course was reassuring overall. Plan: Catherine Watson (NP) performed a home visit for strep testing. Parent advised to continue alternating Motrin and Tylenol as needed for fever management, encourage small sips of cool liquids, and rest. Parent instructed to update the care team with any new concerns or changes. Follow-up check-in on 2026-04-18 confirmed resolution of fever and clinical improvement; no further intervention needed. Medications: - Ibuprofen (Motrin) Dose not specified (existing/recommended) - Acetaminophen (Tylenol) Dose not specified (existing/recommended) Key clinical quotes: "That's all reassuring. Let's continue with the Motrin as needed or Tylenol when you get that in hand — Sips and rest. Keep me updated with any more worries or changes please." "Tell me more about his headache — Is he moving his head around normally?" "I'm sorry — Motrin is fine if his stomach is holding up. Small sips of cool liquid - rest -" Source: Spruce conversation t_2N9PJR7HF7000