CASE NO. 2

A 15 year old female with a history of hay fever develops fever, headache and malaise for 4 days followed by a nonproductive cough and scratchy throat. Despite chicken soup and orange juice, the cough and fever persist, and her mother drags her to your office. On examination, her temperature is 101°, pulse 90 beats/min, BP 110/70, respiratory rate 20 beats/min Physical examination is unremarkable except for scattered rales over the left lower lung, and small bullae in her left tympanic membrane. Chest x-ray reveals a patchy left lower lobe infiltrate. At your request, she makes a heroic effort but is unable to produce sputum

1. What is the  type of pneumonia this patient is likely to have?   Answer

2. What is "atypical pneumonia"?  Answer

3. What is the differential diagnosis of atypical pneumonia?  Answer

4. What is the most likely organism in this patient and why?  Answer

5. Describe Mycoplasma pneumoniae.  Answer

6. What is the pathogenesis of infection produced by these agents? What pathologic changes are produced in the lungs?  Answer

7. How does immunity to Mycoplasma pneumonias develop ? Is reinfection possible?  Answer

8. How is the diagnosis established in atypical pneumonia?  Answer

9. What antimicrobial agent(s) would you use ?  Answer

10. You start the patient on Erythromycin. If he is taking antihistamines, what drug interaction might occur?  Answer