06-06-2009, 11:42 PM
A 37-year-old woman comes to the physician because of an itchy rash over her trunk for 2
weeks. She has not had fever, chills, shortness of breath, chest pain, or gastrointestinal symptoms.
She has a history of recurrent urinary tract infections and has been taking trimethoprimsulfamethoxazole
prophylaxis for the past year. She is in mild distress. Her temperature is 37.5 C
(99.5 F), blood pressure is 96/62 mm Hg, pulse is 78/min, and respirations are 14/min.
Examination shows a maculopapular erythematous rash over the trunk. Laboratory studies show:
Leukocyte count 10,500/mm3
Segmented neutrophils 72%
Bands 1%
Eosinophils 15%
Lymphocytes 4%
Monocytes 8%
Serum
Urea nitrogen (BUN) 12 mg/dL
Creatinine 0.9 mg/dL
Urine
WBC 2/hpf
RBC 2/hpf
Which of the following is the most likely cause of these findings?
A
) Eczema
B
) Medication adverse effect
C
) Staphylococcal skin infection
D
) Streptococcal skin infection
E
) Urinary tract infection
weeks. She has not had fever, chills, shortness of breath, chest pain, or gastrointestinal symptoms.
She has a history of recurrent urinary tract infections and has been taking trimethoprimsulfamethoxazole
prophylaxis for the past year. She is in mild distress. Her temperature is 37.5 C
(99.5 F), blood pressure is 96/62 mm Hg, pulse is 78/min, and respirations are 14/min.
Examination shows a maculopapular erythematous rash over the trunk. Laboratory studies show:
Leukocyte count 10,500/mm3
Segmented neutrophils 72%
Bands 1%
Eosinophils 15%
Lymphocytes 4%
Monocytes 8%
Serum
Urea nitrogen (BUN) 12 mg/dL
Creatinine 0.9 mg/dL
Urine
WBC 2/hpf
RBC 2/hpf
Which of the following is the most likely cause of these findings?
A
) Eczema
B
) Medication adverse effect
C
) Staphylococcal skin infection
D
) Streptococcal skin infection
E
) Urinary tract infection