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2 year old. Respiratory infection, loss of appetite, enlarged cervical lymph node. Penicillin started. Treatment?

This 2-year-old boy experienced an upper respiratory infection 2 weeks prior to hospital admission. Four days prior to admission, anorexia (loss of appetite) and lethargy were noted. The patient was seen in the emergency room 3 days prior to admission. At that time he had a fever of 39.9ºC. Physical examination revealed a clear chest, exudative pharyngitis (sore throat), and enlarged cervical lymph nodes . A throat culture was taken, and a course of penicillin was begun. The child s condition worsened and he became increasingly lethargic. He developed respiratory distress on the day of admission. It was noted that the throat culture from 3 days prior to admission had not grown any group A streptococci. On examination, the child had a fever of 38.9ºC and had an exudate in the throat that was described as a yellowish thick membrane which bled when scraped. The patient s medical history revealed that he had received no immunizations. I need Nursing Care plane for this
Asked On : Sun, 2 Dec 2012
Answers:  1 Views:  1201
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Pediatrician 's  Response
Feb 2013
Hi Christina
In this type of scenario without immunization Diphtheria should be ruled out so better to send smear and culture for diphtheria organisms as this condition requres specific treatment with antitoxin apart from antibiotics and there are life threatening complications are associate with this infection. Till diphtheria ruled out patient should be in absolute bed rest and proper nutrition to be maintained and consultation with an ENT specialist and Infectious Disease specialist or centre is needed.
Answered: Thu, 6 Dec 2012
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