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  #1  
Old 05-31-2012
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Question salmonella diarrhea...does he need antibiotics?

A 30-year-old man is evaluated for a 3-day history of fever and diarrhea. He has not recently
traveled and he is otherwise healthy.
On physical examination, he appears fatigued but not severely ill. Temperature is 38.7C
(101.7F); other vital signs are normal. There is mild diffuse abdominal tenderness to deep
palpation. A stool specimen is submitted for diagnostic testing and is found to be positive for
Salmonella species.
Which of the following is the most appropriate next step in management?
(A) Administer loperamide
(B) Begin oral ciprofloxacin
(C) Begin oral metronidazole
(D) Reassure and set up follow-up phone call
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  #2  
Old 05-31-2012
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sure B
as ciprofloxacin works well on salmonella
used 4 multi drug resistant typhoid
in egypt we used it and give good results
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Old 05-31-2012
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-pt has mild symptoms &normal vital sign ,according to kln=fluid &electrolyte replacement.so(D).BUT U KNOW WHAT IAM ITCHING TO GIVE HIM CIPRO
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I would also say B, salmonella can disseminate so better to tx.
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CIPRO for salmonella
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(D) Reassure and set up follow-up phone call

This is USMLE. You don't give antibiotics here especially with Salmonella as it makes the infection chronic.

How Can Salmonella Infections Be Treated?

Quote:
Salmonella infections usually resolve in 5-7 days and often do not require treatment other than oral fluids. Persons with severe diarrhea may require rehydration with intravenous fluids. Antibiotics, such as ampicillin, trimethoprim-sulfamethoxazole, or ciprofloxacin, are not usually necessary unless the infection spreads from the intestines.
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Quote:
Originally Posted by Novobiocin View Post
(D) Reassure and set up follow-up phone call

This is USMLE. You don't give antibiotics here especially with Salmonella as it makes the infection chronic.

How Can Salmonella Infections Be Treated?
this info from qbank may be helpful
Quote:
so when to give antibiotics in SALMONELLA DIARRHEA?
<2 or >50 or AIDS or patient with bony prosthesis
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Quote:
Originally Posted by tyagee View Post
this info from qbank may be helpful
Also in patients with sickle cell disease.

Quote:
so when to give antibiotics in SALMONELLA DIARRHEA?
<2 or >50 or AIDS or patient with bony prosthesis
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Quote:
Originally Posted by tyagee View Post
this info from qbank may be helpful
First Aid 2012 page 164-1 states that "Antibiotics may prolong symptoms of Salmonela infections. This may help in supporting Choice D.
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Gastroenterology-, Infectious-Diseases, Step-2-Questions

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