Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-04-28 Encounter: Photo review (throat images sent by parent) followed by in-person office visit CC: Persistent headache, low-grade fever, and cough in the setting of ongoing sibling illness. HPI: Nelly (age not specified) had been coughing with siblings since approximately Wednesday April 22. On April 28 she developed a headache and felt warm, prompting her to stay home from school. Temperature was 99.8°F. Tylenol had been given twice that day. Parent sent throat photos for review. On April 29 she was sent home from school with a temperature of 101.2°F. An at-home rapid test later (May 3) was positive for Influenza B; Dr. Hobbs believed this was a late positive and that she had likely already been ill with Flu B during this episode. Assessment: Dr. Hobbs reviewed throat photos and noted the throat did not look significantly red. Flu B was assessed as the most likely cause of her illness in retrospect, more consistent with her symptoms than strep. Dr. Hobbs noted the false positive rate for strep is approximately 15% at this time of year and did not believe she had active Flu B at the time of the May 3 test given how long she had been symptomatic. Plan: Throat photos reviewed remotely on April 28; reassured parent. In-person office visit arranged for April 30 (Edina office, 9:15 AM, then moved up). On May 3, after Flu B test result shared by grandparent (nurse), Dr. Hobbs advised rest as long as cough/breathing were not severely worsened or fever did not spike. No prescription sent based on available transcript. Medications: - Tylenol Dose not specified; given twice on April 28 (ongoing (parent-initiated)) Key clinical quotes: "nice job. not looking too red. how's your overall read on her?" "Flu b makes more sense for the symptoms she was having. False positive rate on strep this time of year is about 15%." "Rest as long as her cough or breathing aren't too bad or if her fever spikes back up" Source: Spruce conversation t_27C02FVS44O00