A 29-year-old previously healthy female presented with a productive cough, fever to 102 oF, and severe headache. She had cervical adenopathy (swollen glands), although she had a nonerythematous throat with no exudate. Chest examination showed crackles bilaterally at the lung base with decreased breath sounds diffusely. This finding was confirmed by chest film that showed bilateral multifocal areas of patchy consolidation. Her neck was not stiff, but because of the severity of the headache, she was admitted to the neurologic service. A spinal fluid was obtained and was negative for bacteria, cryptococcus, and acid-fast smear. Blood cultures and sputum cultures did not produce a pathogen. The patient did not improve on ceftriaxone. On day 3 she was started on erythromycin. On day 4, cold agglutinins were done and were positive. The patient gradually improved although the headache, photophobia, and cough continued for some time QUESTIONS: 1. What is the agent of this disease? 2. Can you explain why the bacterial cultures were negative? 3. Why is erythromycin an effective therapy but ceftriaxone is not?
A 29-year-old previously healthy female presented with a productive cough, fever to 102 oF, and severe headache. She had cervical adenopathy (swollen glands), although she had a nonerythematous throat with no exudate. Chest examination showed crackles bilaterally at the lung base with decreased breath sounds diffusely. This finding was confirmed by chest film that showed bilateral multifocal areas of patchy consolidation. Her neck was not stiff, but because of the severity of the headache, she was admitted to the neurologic service. A spinal fluid was obtained and was negative for bacteria, cryptococcus, and acid-fast smear. Blood cultures and sputum cultures did not produce a pathogen. The patient did not improve on ceftriaxone. On day 3 she was started on erythromycin. On day 4, cold agglutinins were done and were positive. The patient gradually improved although the headache, photophobia, and cough continued for some time QUESTIONS: 1. What is the agent of this disease? 2. Can you explain why the bacterial cultures were negative? 3. Why is erythromycin an effective therapy but ceftriaxone is not?
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
Related questions
Question
A 29-year-old previously healthy female presented with a productive cough, fever to
102
oF, and severe headache. She had cervical adenopathy (swollen glands), although she
had a nonerythematous throat with no exudate. Chest examination showed crackles
bilaterally at the lung base with decreased breath sounds diffusely. This finding was
confirmed by chest film that showed bilateral multifocal areas of patchy consolidation. Her
neck was not stiff, but because of the severity of the headache, she was admitted to the
neurologic service. A spinal fluid was obtained and was negative for bacteria, cryptococcus, and acid-fast smear. Blood cultures and sputum cultures did not produce a pathogen. The
patient did not improve on ceftriaxone. On day 3 she was started on erythromycin. On day 4, cold agglutinins were done and were positive. The patient gradually improved although the
headache, photophobia, and cough continued for some time
QUESTIONS:
1. What is the agent of this disease?
2. Can you explain why the bacterial cultures were negative?
3. Why is erythromycin an effective therapy but ceftriaxone is not?
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