| Author | 15 Posts |
GUEST..........
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A 45-year-old man presents with fever of 40°C (104°F), myalgia, and headache. The patient was originally treated symptomatically for what was presumed to be a viral upper respiratory infection. However, the symptoms persisted and he became short of breath. A chest x- ray revealed interstitial infiltrates, and he was admitted to the hospital for intensive support. CBC revealed a white count of 2000/L, hematocrit of 38%, and platelet count of 75,000/L. SGOT was 240 /L and SGPT was 300 / L. The bilirubin and alkaline phosphatase were normal. In questioning family members while the patient was in intensive care, a history of travel to Cape Cod and a tick bite was obtained. In addition to supportive care, the appropriate therapy is
A Lyme vaccine
B doxycycline
C penicillin
D acyclovir
E chloroquine
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| smitha
Forum Elite
Topics: 53
Posts: 236
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..........B.doxycycline..........
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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i would go with doxycycline.............
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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what do you think smita does is patient suffering from........... :?: :?: :?: :?: :?:
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| Yulia
Forum Elite
Topics: 19
Posts: 240
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could it be babesiosis :?:
it's also tick-borne and endemic here in MA,
and chloroquine for treatment then
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| cherry
Forum Newbie
Topics: 0
Posts: 12
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seems more like Q fever. with the fever, myalgia, headache, chest infection, and hepatitis......RX tetracycline..
but bartonellosis does cause a transient immune suppression but has signs which have not been mentioned.....and RX is penicillin...
So what is the patient suffering from??
:icon_cherry:
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| cherry
Forum Newbie
Topics: 0
Posts: 12
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sorry, im used to tetracycline.. but here it would be doxycycline
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| Yulia
Forum Elite
Topics: 19
Posts: 240
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:oops:
actually it could very well be q-fever
the only thing, i was under impression that q-fever is transmitted by inhalation of aerosols of urine or amniotic fluid of sheep and goats, remembered from kaplan notes, but i guess it's not very accurate then.
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| smitha
Forum Elite
Topics: 53
Posts: 236
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hmmmmm seems like a BIGTIME guess and diagnosis........ :roll: :roll:
But i do agree with yulia about the Q-fever...............
Can it be "relapsing fever" caused by borrelia recurrentis?????? :wink: , i mean with that mountainous exposure and treated before, but still persisting..........well, that's one point which made me hesitate again........"persisting", no mention of "recurring".....hmmmmm, well, that's wat is my guess.......and if that's the answer , doxycycline shud be rite too......... 
iam still waiting for the rite answer shirish and others.........
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| cherry
Forum Newbie
Topics: 0
Posts: 12
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Q fever... contracted from unpasteurized milk, droplet spread and occasionally from tick bites
:icon_cherry:
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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IT'S 101% Q-FEVER...........AND THE TREATMENT IS DEFINITELY DOXYCYCLINE........
HISTORY OF TICK BITE.....FOLLOWED BY UPPER RESP. SYMPTOMS AND DIFFUSE INTERSTITIAL PULMONARY INFILTRATES....FOLLOWED BY GIT SYMPTOMS LIKE HEPATITIS (CHARACTERISTICALLY THERE IS ELEVATED TRANSAMINASES BUT NORMAL BILIRUBIN-A CHARACTERISTIC OF Q-FEVER)......ASSOCIATED MOST OF THE TIMES WITH NORMAL WBC COUNTS AND THROMBOCYTOPENIA...........IT'S NONE OTHER THAN Q-FEVER...............
AND IT'S A NOTIFIABLE DISEASE................
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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GUYS....ENDOCARDITIS CAN BE A POTENTIAL COMPLICATION OF Q-FEVER........
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| Delmar
Forum Senior
Topics: 21
Posts: 128
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Does the word LYME disease ring any bells guys ???????????
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VENI VIDI VICI
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| shirish_sss
Forum Senior
Topics: 32
Posts: 134
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THERE'S NO HISTORY OF RASH, ARTHRALGIAS, OR CNS MANIFESTATIONS.......WHICH ARE CHARACTERISTIC FOR LYME'S....
PLUS LYME'S DOESN'T CAUSE HEPATITIS..........
SO IT COULD NOT BE LYME'S.........
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| Ivonne
Forum Guru
Topics: 54
Posts: 1,443
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B-------------------> Q fever
Good one!!!
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