nida
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A previously healthy 19-year-old male college student presents to his physician's office with 3 weeks of progressive nonproductive cough, mild headache, and fevers. He has had no sick contacts and takes no medications. On further questioning, he mentions a painful rash over his hands and feet for the last 2 days, but he has had no other associated symptoms. His temperature is 38.9°C (102°F), pulse 110, respiratory rate 20, and blood pressure 120/70 with a finger pulse oximetry reading of 95% on room air. He is coughing frequently but has normal breath sounds bilaterally. A picture of his rash is shown in Figure IV-38. A chest radiograph shows bilateral diffuse interstitial infiltrates. The most likely etiology of this patient's illness is
A. Herpes simplex virus
B. Chlamydia psittacosis
C. Mycoplasma pneumoniae
D. Influenza
E. Haemophilus influenzae
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| AAAAA
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The correct answer is A Herpes Simplex Infection
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| nida
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HSV pneumonitis is uncommon except in severely immunosuppressed patients.
This patient is a previously healthy 19-year-old male college student
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| AAAAA
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nida wrote:
HSV pneumonitis is uncommon except in severely immunosuppressed patients.
This patient is a previously healthy 19-year-old male college student
In contrast to the above statement, I have seen quite a few cases of HSV encephalitis at my medical school which is a tertiary referral center.
The patients were all healthy college kids !!
 :
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| achilles
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C - mycoplasma pn.
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| nihal
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mycoplasma pneumonia
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| MAZI
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erythema multiform due to mycoplasma
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| nida
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The correct answer is C.
This is a classic presentation of Mycoplasma pneumoniae in a young male. M. pneumoniae, which lacks a cell wall, can cause pneumonia in any age group but most commonly affects people age 5 to 20. The organism has an incubation period of 2 to 3 weeks and is associated with severe nonproductive cough and headache. Although chest wall tenderness after coughing is common, myalgias, shaking chills, and gastrointestinal symptoms are rare. M. pneumoniae has a number of extrapulmonary manifestations, including erythema multiforme (shown in the question), maculopapular exanthems, myocarditis and pericarditis, encephalitis, and hemolytic anemia. When these conditions occur, it is rare to isolate M. pneumoniae from the extrapulmonary site. Thus, their etiology remains controversial but generally is believed to be immunologic.
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| vinidoc
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Treatment is erythromicin
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