Patient is a 1-year old boy who presents at his primary care physician’s office with fever, labored breathing, thick brown-colored mucous after recent upper respiratory tract infection. He also had been recently treated numerous times for cellulitis in the intertriginous (diaper) area with ulceration that was refractory to topical antibiotics (erythromycin).He was immediately given intramuscular ceftriaxone antibiotics (75 mg/kg). He was hemo-dynamically stable and oxygenating well on room air and was discharged home with follow up care in clinic the next morning. Past Medical History Shortly after cessation of breast-feeding he developed otitis media (ear infection), requiring antibiotic (amoxicilin) therapy and ear tubes placement. At 9 months of age the patient developed life-threatening disseminated Streptococcus pneumonia infection secondary to pneumonia, which was treated with antibiotics (ceftriaxone). The patient has received the following childhood vaccinations: Inactivated poliovirus, HiB, DTaP, HepB Family History The patient is the fifth son of genetically unrelated parents. He was breast-fed by the mother until 6 months of age. The three older sisters and one older brother are normal with no similar history of recurrent bacterial infections. However, a maternal uncle had similar health problems and died at 2 years of age from pneumonia. Do you expect this patient to be suffering from systemic infection? Is an immune response occurring? What based on their presentation and past medical history led you to your answer? Please be specific. Solution Ans: Yes this patient is suffereing from systemic infection and yes immune response is occuring. A maternal uncle had similar health problems and died at 2 years of age from pneumonia..

1. Patient is a 1-year old boy who presents at his primary care physician’s office with fever, labored
breathing, thick brown-colored mucous after recent upper respiratory tract infection. He also had
been recently treated numerous times for cellulitis in the intertriginous (diaper) area with
ulceration that was refractory to topical antibiotics (erythromycin).He was immediately given
intramuscular ceftriaxone antibiotics (75 mg/kg). He was hemo-dynamically stable and
oxygenating well on room air and was discharged home with follow up care in clinic the next
morning.
Past Medical History
Shortly after cessation of breast-feeding he developed otitis media (ear infection), requiring
antibiotic (amoxicilin) therapy and ear tubes placement. At 9 months of age the patient
developed life-threatening disseminated Streptococcus pneumonia infection secondary to
pneumonia, which was treated with antibiotics (ceftriaxone).
The patient has received the following childhood vaccinations: Inactivated poliovirus, HiB,
DTaP, HepB
Family History
The patient is the fifth son of genetically unrelated parents. He was breast-fed by the mother until
6 months of age.
The three older sisters and one older brother are normal with no similar history of recurrent
bacterial infections. However, a maternal uncle had similar health problems and died at 2 years
of age from pneumonia.
Do you expect this patient to be suffering from systemic infection? Is an immune response
occurring? What based on their presentation and past medical history led you to your answer?
Please be specific.
Solution
Ans:
Yes this patient is suffereing from systemic infection and yes immune response is occuring.
A maternal uncle had similar health problems and died at 2 years of age from pneumonia.