A 52-year-old man with chronic eczema was admitted to the Prince of Wales Hospit
ID: 238117 • Letter: A
Question
A 52-year-old man with chronic eczema was admitted to the Prince of Wales Hospital, Hong Kong, with fever and chills. Before admission, he had been treated for infected eczematous lesions for several weeks with oral ampicillin, cloxacillin, and cefazolin. He had no history of hospitalization in the past 10 years, and none of his family members were healthcare workers.
Examination showed an oral temperature of 40°C, blood pressure 95/55 mm Hg, and no audible murmur. Cellulitis in the left leg complicated his eczematous skin lesions. Chest radiograph showed right-middle-zone pneumonia. Neutrophilia (leukocytes 15.5 × 109/L, neutrophils 86%), thrombocytopenia (platelets 55 × 109/L), prolonged activated partial thromboplastin time (43.6 s), and elevated bilirubin level (31 mol/L) were observed.
Two initial blood cultures grew gram-positive cocci in clusters, identified as S. aureus by positive results for catalase and slide/tube coagulase and a negative result for ornithine decarboxylase. Intravenous cloxacillin (2 g every 6 h) was given on days 2–5.
However, the patient's condition progressively deteriorated from day 2 to day 10 with persistent fever, chills, hypotension, and hemoptysis. A repeated chest radiograph showed small lung cavities with fluid, and a thoracic computed tomographic scan confirmed multiple lung abscesses. Results of an initial transthoracic echocardiograph were normal, but a subsequent transesophageal echocardiograph demonstrated tricuspid valve vegetation.
Questions
1.How do you find out if the strain that infected the patient is is MRSA?
2.What antibiotic/s can be substituted?
3.What are the precautions to be taken if this patient was to be hospitalized and why?
4.What would you recommend to do if this patient developed bed sores in the hospital
Explanation / Answer
How do you find out if the strain that infected the patient is is MRSA?
What antibiotic/s can be substituted?
What are the precautions to be taken if this patient was to be hospitalized and why?
What would you recommend to do if this patient developed bed sores in the hospital?
Stage I or II injuries will recuperate if administered to deliberately. Stage III and IV bruises are harder to treat and may set aside a long opportunity to recuperate. Here's the means by which to tend to a weight sore at home.
Diminish the weight on the zone.
Tend to the sore as coordinated by your medicinal services supplier. Keep the injury clean to counteract contamination. Clean the sore each time you change a dressing.
Stay away from assist damage or contact.
Deal with your wellbeing.
Try not to knead the skin close or on the ulcer. This can cause more harm. Try not to utilize doughnut molded or ring-formed pads. They decrease blood stream to the zone, which may cause wounds.
Related Questions
drjack9650@gmail.com
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.