A 55 year old diabetic woman with recurrent foot ulcers presents with pain and swelling of her foot centered around her ulcer. Cellulitis is suspected, a swab of pus from her ulcer reveals Group A streptococci. She has a history of severe allergy to penicillin.
Treatment should ideally include
a) Course of vancomycin
b) stripping of varicose veins
c) Percutaneous thrombolysis
d) Pulmonary Ventilation/Perfusion scintigraphy
e) Administer low-molecular-weight-heparin
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Answer: Course of vancomycin
Explanation:
Depending on culture sensitivities, the therapy directed against Group A streptococci usually is penicillin G, 1 to 2 million units intravenously every 2 to 3 hours. Penicillin-allergic patients may be treated with a cephalosporin such as cefazolin. Vancomycin may be used in cases in which cross-reactivity between penicillin and cephalosporin is of concern, If Haemophilus infiuenzae infection is suspected, then ampicillin is administered in six divided dosages. Alternatively, because of recent emergence of beta-lactamase-producing ampicillin strains, a cephalosporin (cefuroxime or cefotaxime) may be chosen. In the course
Treatment should ideally include
a) Course of vancomycin
b) stripping of varicose veins
c) Percutaneous thrombolysis
d) Pulmonary Ventilation/Perfusion scintigraphy
e) Administer low-molecular-weight-heparin
--------------------------------------------------------------------
Answer: Course of vancomycin
Explanation:
Depending on culture sensitivities, the therapy directed against Group A streptococci usually is penicillin G, 1 to 2 million units intravenously every 2 to 3 hours. Penicillin-allergic patients may be treated with a cephalosporin such as cefazolin. Vancomycin may be used in cases in which cross-reactivity between penicillin and cephalosporin is of concern, If Haemophilus infiuenzae infection is suspected, then ampicillin is administered in six divided dosages. Alternatively, because of recent emergence of beta-lactamase-producing ampicillin strains, a cephalosporin (cefuroxime or cefotaxime) may be chosen. In the course
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