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Old 07-06-2011
aksyonez's Avatar
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Kids 3 month old baby girl with severe cough

A 3 month old female child develops a severe hacking cough during which she turns dusky and appears to choke or to vomit thick profuse clear nasopharyngeal mucus. For 7 days the coughing continues unabated. On physical exam she is afebrile and her lungs are clear. Her chest x-ray is normal. Her WBC is 24,000/mm3 with 15% polymorphonuclear cells and 82% lymphocytes and 3% monocytes. Which of the following antibiotics should be given?

A. Amoxicilin
B. Amoxicilin-Clavulanic acid
C. Erythromycin
D. Tetracycline
E. No antibiotics are necessary
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Old 07-06-2011
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severe productive cough with normal chest x-ray is acute bronchitis, which is mostly viral in origin, mostly lymphocytes and no mention of fever and the character of the sputum(clear) may point to viral etiology: no antibiotics are indicated.
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Old 07-06-2011
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The answer is C. The baby girl has whopping cough or pertussis with a prolonges course, undifferentiated URI followed by machine gun cough and nasopharyngeal mucus that is thick, strangling and clear. The CBC reveals increased lymphocytes, the diagnosis can be made with culture of the organism(Bordetella Pertussis) and the treatment is Erythromycin
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Infectious-Diseases, Pediatrics-, Step-2-Questions

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