Secure Message Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2025-11-12 Encounter: Spruce text message followed by in-person home visit CC: Persistent fever for approximately five days with cough, school dismissal, and labored breathing. HPI: Malcolm, age approximately 5, had been sent home from school the prior Friday with fever and had persistent fever most days since. He seemed briefly better on Monday but was sent home again on Wednesday. His breathing was described as labored but okay. Temperature at school was 102.1°F though parents felt this was high. Strep and influenza were known to be circulating in the school. A home visit was conducted on November 12th. Assessment: Prolonged febrile illness with respiratory component; influenza suspected given community circulation and duration. Strep less likely given duration of illness. Labored breathing warranted in-person evaluation. Plan: In-person home visit on November 12th. Breathing treatments (albuterol) discussed. Continued fever monitoring. Temps in high 99s on day of visit, noted as less concerning (under 100.5). Key clinical quotes: "how's Malcolm's breathing? I'm seeing flu in kids. Strep doesn't last that long" "less than 100.5 is normal" Source: Spruce conversation t_27C02FVS44O00