A Study On Infectious Disease

1222 Words5 Pages
Trhia Vu
N01390867
Palm Beach
IAI Script- Secondary Peritonitis

A) Pharmacist: Student pharmacist, I would like to go over John Smith’s case with you today so we can discuss the appropriate therapy for him.

A) Pharmacy Student: Sounds great! I am currently learning about infectious disease. This will help test my knowledge and really help me become a great clinician.

A) Pharmacist: Let’s get to it! John Smith is a 19-year-old male who arrived at the emergency room complaining of nausea and vomiting beginning soon after experiencing pain on the right side of his lower abdomen and lack of appetite for the past 14 hours. He has a temperature of 101.2 F, also tachypnea with no known drug allergies. What labs and test do you think we should
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Pharmacy student, based on your knowledge, can you interpret these results for me?

B) Pharmacy student: Sure, his elevated white blood cell count is an indication of a bacterial infection. We can also look at the bands to see if it is elevated as well, it should be less than 5%. The CT scan helped clarify the diagnosis appendicitis because his appendix is larger than 6 mm in diameter. There is inflammation in the surrounding peritoneal fat possibly due to impacted mass of feces causing the obstruction and the free fluid indicates spillage of contents into the peritoneal cavity.

B) Pharmacist: Very well done student pharmacist. We will need to ensure this patient has adequate IV fluids to prevent dehydration. What other labs should we order for JS?

B) Pharmacy Student: We would need to obtain a sample of the peritoneal fluid using paracentesis, and then perform a gram stain and blood culture to see if there is bacterial growth.

B) Pharmacist: We will check back on those labs as soon as they are received. JS does appear to have secondary peritonitis, most commonly appendicitis. How can we classify this?

C) Pharmacy student: The most appropriate classification for JS’s appendicitis is high-risk community acquired infection.

C) Pharmacist: That is correct! What are the most common pathogens for this type of infection, student pharmacist?

C) Pharmacy student: We must cover our gut bacteria and use agents with broader coverage of gram-negative pathogen E.
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