Magazine article Journal of Continuing Education Topics & Issues

Cases in Clinical Microbiology

Magazine article Journal of Continuing Education Topics & Issues

Cases in Clinical Microbiology

Article excerpt

The case description on this page and its follow-up discussion presented elsewhere in this issue is the 22nd in a series of articles presenting clinical microbiology cases that will appear in this journal. Readers should study the case description below and formulate their own answers to the questions posed. After coming up with a solution to the problem, turn to page 22 in this issue and read the Case Follow-up and Discussion. This is followed by Questions for STEP Participants on page 25.

Joel E. Mortensen, PhD, MLT(AMT), Series Editor

Case Description: An 18 year old female with a history of a liver transplant (1998) secondary to biliary atresia, presented to Cincinnati Children's Hospital May 17 with persistent fever and abdominal pain. A urine culture was collected and cefadroxil was prescribed due to concern that a urinary tract infection was the cause of the fever. After 24 hours, the urine culture was reported as negative. Her fevers persisted, so she was referred to the emergency department for further evaluation. In the emergency department, she had a fever of 104.8[degrees]. She denied nausea, vomiting, diarrhea, as well as dysuria. Although she had no cough or congestion, chest x-ray showed a small left pleural effusion. Other laboratory tests were within normal range. On May 21, the patient's respiratory status declined. Chest x-ray showed bilateral lower lobe infiltrates. She was transferred to the Pediatric Intensive Care Unit (PICU) for respiratory distress. In the PICU, the patient was intubated. …

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