07-22-2005, 12:45 PM
2 yr old biy has fever and cough for 2 days. Had strep pnenomonia meningitis at 1 yr old, str pneun bacteremia at 18 months and pneunomonia at 22 mo's. 2 maternal uncles died before 2 yrs old from "infection". Temp is 39.8, pulse 150, and respiration 60/min. Exam shows subcostal etractions on inspiration.
Lab results:
hemoglobin 10g/dl
leukocyte count 36000/mm3
...segmented neutrophils 70%
...bands 20%
...lymphocytes 8%
... monocytres 2%
platelet count 240,000/mm3
serum
... igA < 5mg/dL
... igG 30mg/dL
... igM <5mg/dL
chest Xray shows an infiltrate of the left upper lobe. what is appropriate mgmt?
1. re-exam in 12 wks
2. prednisone therapy only
3. prednisone, vincristine, doxorubicin, asparaginase, and methotrexate therpy
4. zidovudine (AZT) lamivudine (3TC) and ritonavit therapy
5. intravenous immunoglobulin infusion
6. bone marrow transplant
7. thymus transplant
Lab results:
hemoglobin 10g/dl
leukocyte count 36000/mm3
...segmented neutrophils 70%
...bands 20%
...lymphocytes 8%
... monocytres 2%
platelet count 240,000/mm3
serum
... igA < 5mg/dL
... igG 30mg/dL
... igM <5mg/dL
chest Xray shows an infiltrate of the left upper lobe. what is appropriate mgmt?
1. re-exam in 12 wks
2. prednisone therapy only
3. prednisone, vincristine, doxorubicin, asparaginase, and methotrexate therpy
4. zidovudine (AZT) lamivudine (3TC) and ritonavit therapy
5. intravenous immunoglobulin infusion
6. bone marrow transplant
7. thymus transplant