Dr.D
Forum Senior
Topics: 22
Posts: 191
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A 6-day-old, male, Caucasian infant is brought to the office by his mother because he is not eating well. He rejects the milk whenever she tries to feed him. He sleeps all day, and it is very difficult to rouse him. Two days ago, he was discharged from the hospital, where he was kept under observation due to jaundice. There were no complications during his mother's delivery or labor. He has no other medical problems. His family history is not significant. He is currently not taking any medications. He is febrile and tachycardic. Physical examination reveals a sleepy and poorly reactive infant. There is no focal neurologic deficit, but generalized hypotonia is observed. Laboratory tests reveal the following:
CBC
Hb
12.1 g/dL
MCV
89fl
Platelet count
400,000/cmm
Leukocyte count
18,000/cmm
Segmented neutrophils
80%
Bands
6%
Lymphocytes
14%
Serum Chemistry
Serum Na
144 mEq/L
Serum K
3.8 mEq/L
Chloride
107 mEq/L
Bicarbonate
23 mEq/L
BUN
16 mg/dL
Serum creatinine
0.8 mg/dL
Calcium
9.7 mg/dL
Blood Glucose
64 mg/dL
LFT
Total bilirubin
9.8 mg/dL
Direct bilirubin
2.8 mg/dL
Alkaline phosphatase
250 U/L
Aspartate aminotransferase
27 U/L
Alanine aminotransferase
30 U/L
Blood and urine cultures are obtained. Chest x-ray is ordered. Which of the following pharmacotherapy is the most appropriate for this patient?
A) Ampicillin and ceftriaxone
B) Trimethoprim-sulfamethoxazole
C) Ampicillin and cefotaxime
D) Ceftriaxone and amikacin
E) Ceftriaxone and vancomycin
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| PGI2alpha
Forum Elite
Topics: 7
Posts: 447
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A? suspecting and treating fr meningitis early...
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| oggn
Forum Elite
Topics: 52
Posts: 169
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Ampicillin and cefotaxime.No ceftriaxone in neonates coz of hyperbillirubenemia
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| robin082006
Forum Hero
Topics: 471
Posts: 5,125
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C
___________________
The Key to Succeed is Patience.
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| dr_singh246
internal medicine pgy2
Topics: 235
Posts: 561
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whats the correct answer.
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to love when it can be lost, to go on when progress seem futile and to believe in every fiber of your body. to live , have hope and faith and to never give in.... dr_singh246@yahoo.com
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| starcraftbw
Forum Senior
Topics: 13
Posts: 166
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C
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| hanwin
Forum Senior
Topics: 6
Posts: 157
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C
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
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C ampicillin and cefotaxime
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Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| jvo_md
Forum Senior
Topics: 22
Posts: 189
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Oggn can you explain why not ceftriaxone because of the hyperbilirrubinemia?
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| jvo_md
Forum Senior
Topics: 22
Posts: 189
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Never mind.... Just found out
http://jac.oxfordjournals.org/cgi/content/abstrac...
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