10-31-2009, 06:14 PM
32. A 5-month-old boy is brought to the physician
because of a
24-hour history of fever, cough, noisy breathing, and
difficulty feeding.
His symptoms began 3 days ago with nasal discharge,
mild cough, and
chest congestion. He appears somewhat irritable and
is crying. His
temperature is 38.5 C (101.3 F), pulse is 108/min, and
respirations are
32/min and shallow with a prolonged expiratory phase.
On examination, the
throat appears normal. A few small anterior and
posterior cervical
nodes are palpable. Both eardrums are pink but have
normal landmarks and
mobility. There is good air entry with diffuse
bilateral expiratory
wheezes on auscultation. An x-ray film of the chest
shows hyperinflation.
Which of the following is the most likely pathogen?
A
) Adenovirus
B
) Haemophilus influenzae
C
) Mycoplasma pneumoniae
D
) Respiratory syncytial virus
E
) Streptococcus pneumoniae
because of a
24-hour history of fever, cough, noisy breathing, and
difficulty feeding.
His symptoms began 3 days ago with nasal discharge,
mild cough, and
chest congestion. He appears somewhat irritable and
is crying. His
temperature is 38.5 C (101.3 F), pulse is 108/min, and
respirations are
32/min and shallow with a prolonged expiratory phase.
On examination, the
throat appears normal. A few small anterior and
posterior cervical
nodes are palpable. Both eardrums are pink but have
normal landmarks and
mobility. There is good air entry with diffuse
bilateral expiratory
wheezes on auscultation. An x-ray film of the chest
shows hyperinflation.
Which of the following is the most likely pathogen?
A
) Adenovirus
B
) Haemophilus influenzae
C
) Mycoplasma pneumoniae
D
) Respiratory syncytial virus
E
) Streptococcus pneumoniae