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A 43 Yr old African-American woman went to her family physician whit 38 C (100.4

ID: 10077 • Letter: A

Question

A 43 Yr old African-American woman went to her family physician whit 38 C (100.4 F) fever, watery diamhea and abdominal cramps over the previous day. Althought born in Nigeria, she'd come to the US at the age of 7 and had lived the greater Washington DC area since. She worked for the US State Department and had returned from Laos, in SE Asian next to Vietnam, a few days carlier. She said she'd returned to Vientiance (the capital city) two nights before her flight home and had spent the previous week before that in a remote area in Northem Lao in two villages, neither of which had indooor plumbing Suspecting several possible infections, the physician gave her a starter pack (2 dosed) of tetracycline and a prescription for 10 day's supply. Which she filled that night. The next morning when office hours opened the woman was waiting to beseen. Her fever was now 39 C (102.2F) and she said she'd taken the medicine, but the cramps had totten very bad and she'd had three bolldy stools that morning. The physician changed her medicine to ciprofloxacin and give her enough sample for a week. The next day, she called the doctor's office, said her fever was still 39 C amdjer irome was mpw reddosj-pramge omcp;pr. She also said she feltweak and short of breath, then she repeated the phace but said she was short of money, not breat which the doctor knew want't true. What type of illbess did this patient have (i.e. was it simple gastrocnterits, lower GI discess of enteric infection with complications, etc.)? 2) what organism was it caused by and howe do you know this for sure? #) What should be done to treat thjis patient sucessfully? (NB: be thorought AND completer here!) 4) Did the intial treatment influence this case in any way? %) What attribute of thepathogen led to this dicease>? 6) Will antibiotics needtobe used and if so, how will you determine which are to prescribe?

Explanation / Answer

she needs to be given norfloxacin with tinidazole antibiotic for that treatment i guess that was caused due to bacteria and enteric infection with complications she should use above antibiotic for a week and should have more fluids till the patient feels good

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