[NP-Clinical] Pneumonia in August

[David or Diane Dito]

Linda,

 

I would do a stool cx, if for no other reason than you've been on
antibiotics at least a couple of times this year from what you've said. With
the IgA deficiency and abx use, you'd be just as prone-if not more so-to C.
diff or another infectious diarrheal illness as the next person, so
culturing is advisable. You could also check with your health department to
see if there's a known outbreak in your area (there's a Shigella outbreak in
the St. Louis area currently, for example). If you can produce sputum for
cx, I'd send that off, too. If you have a resistant bug, it'll still grow
out. Did you have CXR to confirm infiltrate?

 

I don't know much about IgA deficiency, but I'm sure someone on this list
does. Is gamma globulin injection (to increase circulating antibodies) a
possibility? Not to mention ensuring that all of your vaccines are
up-to-date.

 

I hope you're feeling better soon.

 

Diane Dito

 

  _____  

From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Linda Marie De Zago
Sent: Wednesday, August 15, 2007 7:55 PM
To: 'NP Clinical'
Subject: RE: [NP-Clinical] Pneumonia in August

 

Hi Melissa - 

 

Interesting that you bring up Legionella. My cough has been very
non-productive but the diarrhea, h/a, myalgias, and fever have been
outrageous. I already started on my Ketek* and so far I have nothing to
expectorate for a culture. How soon after starting an Abx can one donate a
sputum for C&S? Also - is there any point to obtaining a stool culture?

 

Thanks- Linda

 

P.S. I have an allergy to the quinolone class (anaphylaxis) and in April had
a 3 week bout of drug resistant H. influenza. 

PSS. My supervising doc says "we need to do something to build up your
resistance."  Any suggestions?

 

  _____  

From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Melissa Spurr
Sent: Wednesday, August 15, 2007 4:25 PM
To: NP Clinical
Subject: Re: [NP-Clinical] Pneumonia in August

 

Linda -

Sorry to hear of your illness.  You need to get sputum culture & CXR.
Interesting that you have the diarrhea - I just read an article on pneumonia
on Medscape that discussed clinical & radiologic features of CAP and other
types - mentioned that Legionella is associated with diarrhea, headache,
myalgias, dyspnea & cough.

 

Macrolide or doxycycline would probably cover.

 

Good luck!

Melissa

 

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