gr8doc
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I came across this question & a little confusing. Will appreciate your inputs.
A 13 yr girl, 1 week history of sorethroat and non productive cough. Previously healthy and no exposure to anyone sick. Not on any medications. O/E normal O2 sat, low grade fever. rest normal. which of the following is the mostr appropriate pharmacotherapy?
A. Amoxicillin
B. Cefazolin.
C. Acetaminophen.
D.Erythromycin.
E. Trimethoprim-Sulfamethoxazole.
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| neuroblastoma
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amoxicillin
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| gr8doc
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Why ? can you please justify ? What do you think is the diagnosis here ?
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| Drtweetie
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Answer: C. Acetaminophen
I think the dx is influenza: sore throat, nonproductive cough, low grade fever. Zanamivir or oseltamivir could be given within 48 hours of sxs. . She's been experiencing sxs for 1 week, and she has low grade fever, so I'd give her antipyretics i.e acetaminophen. Her symptoms otherwise do not justify treatment for AOM, pneumonia, or UTI
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| liliaeliz
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C
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| elitoki
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Acetaminophen.
pt has just URI, common cold.
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| gr8doc
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Thanks for responses. How about the answer Amoxicillin, thinking it to be a strep pharyngitis ? & not just thinking it to be another viral pharyngitis & treating it symptomatically or with the antivirals as suggested by Drtweetie ?
And the real answer is the shocking of all along with the strange explanation.
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| neuroblastoma
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will you consider 1 week history of sore throat as VIRAL INFECTION?
though i agreed we give acetaminophen as supportive care for fever in viral .
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| gr8doc
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I agree with you neuroblastoma & i had picked Amoxicillin as the answer, but the answer given is Erythromycin with the explanation, this is a case of Mycoplasma pneumonia & should be treated with a Macrolide. ?????? 
I was pretty shocked to see this answer and the explanation & so thought of sharing it with all.
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| neuroblastoma
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hmm,, well, i didnt notice about non-productive cough related to lungs..(atypical )
but bacterial phryngitis can present with productive cough??staph-strep==so amxocillin.
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| dermatology
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- more than 5 years age pneumonia ---- S pneumoniae and M pneumoniae ( only Cause)
- kid is doing fine --- walking pneumonia ---- M pneumoniae
- treatment --- erythromycin ....
Edited by dermatology on 08/27/07 - 05:13 AM
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| Justice
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I never saw influenza with a low grade fever...
This is atypical pneumania that could be treated with D.Erythromycin
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| elitoki
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Most common colds are caused by infection by rhinovirus. Other viruses causing colds are coronavirus, human parainfluenza viruses, human respiratory syncytial virus, adenoviruses, enteroviruses, or metapneumovirus.
This young child just has low grade fever x 1 week, that could be explained by natural course of common cold. The symptom can last for 1wk ~14days. Self limited.
Infulenza is severe form of Common cold, so I think it is not the case. Also, with low fever without any other symptoms that is getting worse.... I don't think in bacterial case will be low symptom during one week.
Do not give antibiotic in mild disease without symptoms because you will created more bacteria resistant antibiotic cases.
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| gr8doc
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point well taken 
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