Jul 27, 2018

A 19 year old college student presents to the university student health center complaining of severe...

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A 19 year old college student presents to the university student health center complaining of severe coughing spells for the last four days, following initial symptoms of coryza and malaise. She is afebrile. Her medical history is uneventful, and immunizations are up to date. She is a member of the basketball team. During weekends, she babysits a 10-month old and a 2 year old. In terms of management of contacts, which etiological agent is the most important to include in the differential diagnosis?

 

a. Streptococcus pneumoniae

b. Mycoplasma pneumoniae

c. Bordetella pertussis

d. Influenza virus

e. Legionella pneumophila

 

 

The answer is c.

Pertussis has been recognized with increased frequency in the United States among young adults and adolescents who were previously immunized. The immunity provided by the vaccine is limited and fades over time. The infection can be particularly severe in children under the age of 1. Antibiotic prophylaxis with erythromycin is recommended for all household and close contacts to prevent disease and outbreaks. The symptoms are not typical of influenza, legionellosis, or pneumonia due to streptococci. Prophylaxis of contacts is not recommended for mycoplasma infections; it is much less contagious than pertussis.

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