Patient Encounter 1

A 55-year-old man presents with headache, fever, abdominal pain, and bloody diarrhea for 48 hours. He states that his wife had similar symptoms several days ago. His stool Gram stain reveals the presence of leukocytes, and his WBC is 52 x 103/mm3 (52 x 109/L).

What test should you send?

Stool culture showed many Shigella sonnei.

What treatment do you recommend?

Table 76-2 Antibacterial Therapy for Shigellosis

Age-nt

Adult Domgr

IWiilm Outage

fienaLKepaUc Doting ConildfratlenT

LevCflOKKbl

irtij h Lilly * 1 H.Li)".

nol.>1 if» uu' ir |= i7ii'mK !■: ■,'. Mi.ir1

OCIS-tl WO riiij < iixi. thflfi

10 jKiM OML

ISO mg dally

Citl lO-IWiialy^SWmgonct?,

Then JW mg my ollvv djy

Cipro itnaci"

HO ng twice daily« 3dayt

10 mg/kg 1wcie daily * 5 days

CiCl le« than 30l/dialytlt: sane dose

-:jivimi daily

Nolltuac«!

400 mq twice daily * 3 days

Nol appowd r¡y use in patients lesi than

CrCI lO-Jft "tOO mg daily

lSirsH-Okl

(TiCLirtillyjri 10 iWirXjtLuly

Arithrom^ln

SOQmgdaiyx

10 mg/kg daily * 3 days

No dougf* adjustment reoevsaiy

Hif-iHimin

TOO mi) i luee limes daily >M dAj-i

Nqi appendfc vie inpatients Ins than

lack of mfniniAiKm n?f)ardinq ren/i!

12 year-oH.

Insufticlency

Nodoidijtidjuilincru nCi^Mfy

for hppiatk: impairment

OQ, ri\3i Mmclrawi iml /mil

OQ, ri\3i Mmclrawi iml /mil

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