Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Infectious Diseases


Answer 1
  1. Viridans streptococci. Viridans streptococci are an increasing cause of blood stream infections in neutropenic patients with cancer. Risk factors include high-dose cytosine arabinoside, antimicrobial prophylaxis with fluoroquinolones or trimethoprim-sulfamethoxazole, severe neutropenia, and oral mucositis. In some patients, a toxic shock­like syndrome (eg, hypotension, rash, palmar desquamation) and rapid progression to acute respiratory distress syndrome can occur. Moreover, there is increasing resistance of viridans streptococci to penicillin and a variety of other antibiotics; hence, vancomycin is the preferred agent for empiric therapy in these situations. Although all of the other pathogens can cause serious infections, viridans streptococci is the most likely pathogen given this clinical scenario.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj