Case #4 A twenty-four year old non-productive cough for the past ten days that h

Question

Case #4 A twenty-four year old non-productive cough for the past ten days that have not improved with over-the-counter medications. Lung exam is significant for bilateral rales and rhonchi. Laboratory is significant for cold- antibody graduate student presents to the university health service complaining of fever and cough . What is the most likely diagnosis? .What is the most likely causative agent? What is the drug of choice? List other antimicrobials that may be effective against this organism

Explanation / Answer

1. The diagnosis result and symptoms indicate pneumonia (bronchopulmonary infection). In this case, fever and non productive cough starts early while bilateral rale and rhonchi in lungs and positive cold agglutinin can develop after 8 to 15 days.

2. The most likely causative agent is mycoplasma species, mycoplasma pneumoniae.

3. M. pneumoniae infection is self limiting but physician generally treat the condition with different type of antibiotics by considering the age of the patient. Here the patient is adult and therefore the most effective antimicrobial is fluoroquinolones (eg. ciprofloxacin, ofloxacin etc). Tetracyclines (like doxycycline, minocycline, oxytetracyclines) are also effective in this case.

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