week 7 discussion

The child presenting with cough.

MD, a previously healthy 5-year-old white female, is brought to your clinic by her father because of difficulty breathing for 1 day. Two days prior she developed a runny nose, cough, and low-grade fever; her maximum temperature was 101 degrees F (38.3 degrees C) yesterday. Her temperature this morning was 103 degrees F (39.4 degrees C) and she was breathing fast, working hard to breathe. Her mother was concerned and had MD’s father bring her in to be seen because she had to go to work. MD’s appetite is fair. She takes liquids well, but her solid intake has decreased. MD’s father denies that his daughter has had any nausea, vomiting, or diarrhea. Her activity level is good. She has had no recent contact with others with respiratory or other illnesses and does not attend daycare or preschool. Her past medical history is negative for allergies or asthma. She is not taking medications other than Tylenol (acetaminophen). Her last dose of Tylenol was yesterday evening before bedtime. Her immunizations are up to date by record review, and she has no known drug allergies, hospitalizations, or surgeries.

MD’s father states her cough is wet sounding, productive, and is persistent throughout the day. He describes the sputum as yellowish in color. Her father said MD complained of a mild headache earlier this morning but said she didn’t have a sore throat or lethargy.

Questions

1. Explain the findings of pneumonia typically found upon physical examination.

2. List differential diagnoses for pneumonia.

3. Outline the antibiotics used to treat Mycoplasma pneumoniae in an outpatient setting.

4. Describe circumstances that warrant hospitalization for an infant or child with pneumonia.

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