WBR280

Author	PageAuthor::Gerald Chi
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Microbiology, MainCategory::Pharmacology
Sub Category	SubCategory::Head and Neck, SubCategory::Musculoskeletal/Rheumatology
Prompt	[[Prompt::An 8-year-old girl with a history of thalassaemia major presents to the emergency department with low-grade fever, leg pain, and malaise for the past week. Her blood pressure is 110/60 mm Hg, heart rate is 90/min, and temperature is 37.8 ᵒC (98 ᵒF). On physical examination, tibia is red, swollen, and tender to palpation. Two sets of blood culture are positive for a gram-negative bacteria and the diagnosis of osteomyelitis is made. If the physician decides to start her on antibiotics, which of the following drugs should be used in this case?]]
Answer A	AnswerA::Intravenous ciprofloxacin
Answer A Explanation	AnswerAExp::Correct - Intravenous ciprofloxacin is the drug of choice for Salmonella osteomyelitis.
Answer B	AnswerB::Intravenous linezolid
Answer B Explanation	AnswerBExp::Incorrect - Intravenous linezolid may be used as an alternative regimen for MRSA osteomyelitis.
Answer C	AnswerC::Intravenous nafcillin
Answer C Explanation	AnswerCExp::Incorrect - Intravenous nafcillin may be used as a primary regimen for S. aureus osteomyelitis.
Answer D	AnswerD::Intravenous vancomycin
Answer D Explanation	AnswerDExp::Incorrect - Intravenous vancomycin may be used as an alternative regimen for S. aureus osteomyelitis.
Answer E	AnswerE::Intravenous cefazolin
Answer E Explanation	AnswerEExp::Incorrect - Intravenous cefazolin may be used as a primary regimen for S. aureus osteomyelitis.
Right Answer	RightAnswer::A
Explanation	[[Explanation::Patients with a history of hemoglobinopathy such as sickle cell disease and thalassemia are prone to have osteomyelitis secondary to Salmonella infection. Other risk factors include transfusions and iron chelation therapies. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::Salmonella
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::