Natasa
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•A 55-year-old diabetic male complains of fevers to 38.3, worsening erythema, and purulent drainage from a chronic foot ulcer. His WBC is 14,800 with 83% neutrophils. ESR (erythrocyte sedimentation rate) is 76 mm/hr. What is the best appropriate therapy in this setting? A.Amoxicillin / Clavulanic Acid B.Imipenem/Cilastatin C.Piperacilin/Tazobactam D.Ampicilin/Gentamicin
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| robin082006
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A?
Because it may be pseudomonas infection.
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| mjl1717
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answer-c-pipercillin tazobactam
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| msyamp
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our mjl hero o pharma has got it. hey mj i dont means you arnt doing well in others but i know you have passion for this
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| mjl1717
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I wasnt totally sure but I assume the tipoff was discharge and diabetics being prone to infections(such as Psuedo monas or gram negative) Anyone know if the sed rate of 76 was relavant??? ???Psuedomonas is known for liking cool areas like the foot and having at least a couple of discharges.
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| Natasa
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Goood,the answer is C of course!
Sedimentation rate is relevant in this question(this was one of my questions on a PhD test on 2nd year)-sedimentation rate is IMPORTANT as it is pointing out to a possible osteomyelitis in this case and Pseudomonas as most likely cause in a diabetic patient.The next question as an extension of this one was:WHAT IF NO IMPROVEMENT WAS MADE WITH THIS THERAPY?WHAT WOULD YOU DO NEXT-THERAPY WISE?
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