Case History 2 The patient is an 18 – day – old female who at presentation was b

Question

Case History 2 The patient is an 18 – day – old female who at presentation was brought to the emergency department by her mother after a three – day bout of coughing. Her mother also reported that her daughter had been “spitting up” more than usual and had episodes of tachypnea. During the initial exam, a rapid respiratory syncytial (RSV) test was obtained with negative results. A review of systems was notable only for a nonproductive cough. Her pulse was 168 beats/min, her respiratory rate was 32 inspirations per minute, and oxygen saturation was 92-95% on room air. Her complete blood count was significant for a white blood cell count of 15,300 cells/µl with an absolute lymphocyte count of 10,900 cells/µl. The mother had a chronic cough of 4 weeks duration but had been afebrile. Six weeks before the patient’s admission, her 10 – year – old brother also had a prolonged coughing illness that responded to breathing treatments and inhaled steroids. After initial examination, the child was admitted to the hospital. Her initial hospital course was uneventful, and she was discharged after 2 days. However, she was readmitted the following day with worsening respiratory symptoms. Over the next several days, she had increasing difficulty breathing, tachypnea up to 100 breaths per minute, and oxygen saturations in the low 80s during coughing episodes. She was admitted to the pediatric intensive care unit for respiratory support. She had an extremely complicated and prolonged intensive care unit course that included pulmonary hypertension, acute respiratory distress syndrome, and health care – associated pneumonia. After a 10 – week hospital stay, she was eventually discharged to return home, where her recovery was uneventful.

A vaccine exists to prevent infections of this pathogen. Explain why and how this patient was infected. What does this case tell you about the vaccine?

Vaccine strategies for preventing infections with this organism have recently changed. What changes in the vaccine are making better prevention possible? What groups of individuals should receive this new vaccine?

What type of isolation precautions should have been used while the patient was in the hospital?

Explanation / Answer

This patient was infected by pneumonia due to the mixed attack of bacteria and virus causing inflamantaion in the lungs and the settle in alveloi of lungs and when person breathe they get inside and affect the lungs. This is beacuse of coming in the contact of infected person who might cough or sneezied in fornt of her.

This case tell us that this patient require type-1 type of vaccine which is PCV13.

There is strong evidence for vaccinating children under the age of 2 against Streptococcus pneumoniae (pneumococcal conjugate vaccine) i.e is PCV13 for the childe under age 2 and older above 65.

Proper oxygen should be provided, fluid should be given in proper amount, avoid contacting with other people and clean environment should be provided.

Related Questions

Navigate

• Browse (All)
• Browse C
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.