Abdomen, Pelvis, and Perineun

Update January 14, 2020

Management & Treatment
Definition
Prevention
Pathogenesis, Pathology & Pathophysiology
Study Question

Content 4

A patient is diagnosed with hyperthyroidism and has been started on propylthiouracil (PTU). Six weeks later, he comes to the emergency room complaining of fever and a sore throat. He has a temperature of 102°F and a tonsillar exudate. A CBC is performed and shows a WBC of 1500 with 5% neutrophils, a hematocrit of 38, and a platelet count of 200,000. The PTU is stopped. What is the appropriate therapy?

Start the patient on amoxicillin and schedule him to return to clinic the following day for follow-up of his throat culture.

Admit the patient to the hospital and begin broad-spectrum antibiotics.

Start the patient on amoxicillin and admit for observation.

Admit the patient to the hospital and begin broad-spectrum antibiotics and Granulocyte Colony Stimulating Factor (G-CSF) and Granulocyte/Macrophage Colony Stimulating Factor (GM-CSF).

Next Question

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The correct answer is D. You answered A.

Explanation:

Infection with high fever in a severely neutropenic patient is life-threatening and requires a prompt and full investigation of microbial pathogens and prompt initiation of antimicrobial therapy and administration of G-CSF, or possibly GM-CSF, to stimulate neutrophil production. (The answer is D.)

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Neutropenia

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