07-24-2009, 03:36 PM
23.
A 2-year-old boy is brought to the physician because of fever and cough for 2 days. He had Streptococcus pneumoniae meningitis at the age of 1 year, S. pneumoniae bacteremia at the age of 18 months, and pneumonia at the age of 22 months. Two maternal uncles died before the age of 2 years from "infection." His temperature is 39.8 C (103.6 F), pulse is 150/min, and respirations are 60/min. Examination shows subcostal retractions on inspiration. Laboratory studies show:
Hemoglobin 10 g/dL
Leukocyte count 36,000/mm3
Segmented neutrophils 70%
Bands 20%
Lymphocytes 8%
Monocytes 2%
Platelet count 240,000/mm3
Serum
IgA
A 2-year-old boy is brought to the physician because of fever and cough for 2 days. He had Streptococcus pneumoniae meningitis at the age of 1 year, S. pneumoniae bacteremia at the age of 18 months, and pneumonia at the age of 22 months. Two maternal uncles died before the age of 2 years from "infection." His temperature is 39.8 C (103.6 F), pulse is 150/min, and respirations are 60/min. Examination shows subcostal retractions on inspiration. Laboratory studies show:
Hemoglobin 10 g/dL
Leukocyte count 36,000/mm3
Segmented neutrophils 70%
Bands 20%
Lymphocytes 8%
Monocytes 2%
Platelet count 240,000/mm3
Serum
IgA