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Old 09-23-2012
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Arrow Gyrus Daily Questions; Internal Medicine #24

Which of the following is the most appropriate therapy for a 60-year-old male with 2 weeks of productive cough, fever, shortness of breath, and the chest radiogram as shown in the following figure?


A. Cephalexin
B. Ciprofloxacin
C. Clindamycin
D. Penicillin
E. Vancomycin

Gyrus Daily Questions; Internal Medicine #24-xray.jpg
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anomali (09-23-2012), Awwad (09-24-2012)



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Old 09-23-2012
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i think C.....looks like he suffers from lung abscess
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Old 09-23-2012
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Quote:
Originally Posted by anomali View Post
i think C.....looks like he suffers from lung abscess


Yes You are correct..

The answer is C. The radiograph describes a lung abscess that most likely is due to anaerobic infection. The anaerobes involved are most likely oral, but Bacteroides fragilis is isolated in up to 10% of cases. Vancomycin, ciprofloxacin, and cephalexin have no significant activity against anaerobes. Most oral anaerobic strains have the capacity to produce β-lactamase. For many years penicillin was considered the standard treatment for anaerobic lung infections. However, clinical studies have demonstrated the superiority of clindamycin over penicillin in the treatment of lung abscess. When there
are contraindications to clindamycin, penicillin plus metronidazole is likely to be as effective as clindamycin
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Infectious-Diseases, Internal-Medicine-, Pulmonology-, Radiographs-, Step-2-Questions

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