01-03-2007, 07:35 PM
Rxed but no improvement . what do u do next ???
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pneumonia - zosima
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01-03-2007, 10:08 PM
hmm i dont know
culture.. antibiotic sensitivty test rule out immunosupression.... eg elisa for hiv rule out bronchogenic Ca
01-03-2007, 10:19 PM
my master always told me first ask if the patient got his medicine or not
01-04-2007, 01:36 AM
no improvement radiologically or clinically.. if clinical improvement and radiologically same give 4- 6 wks it to resolve on the xray.. if no clinical improvement do cbc and sputum culture and treat with macrolde (azithro/clarithro to cover for atypical pneumonia) diagnostically u can do cold agglutinins for mycoplasma..if old age and strong smoking history think of alternate diagnosis like malignancy if no response to antibiotics..lastly u can plan a bronchoscopy for better culture sample after a HRCT chest
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