diagnostic treatment for patient with severe UTI taking SMX/TMP and now has fever 103.6F, taachypnea, crackles and lung consolidation?
Discussion Part Two (graded)
The patient is diagnosed with a severe urinary tract infection (pyelonephritis), and you
decide to prescribe him sulfamethoxazole/trimethoprim (SMX/TMP) beginning with 2 g
initially as a loading dose, followed by 1 g as a maintenance dose BID. Over the next
couple of weeks, the symptoms associated with his UTI diminish, and his mental status
improves. However, Ms. Webb brings him back to your clinic with symptoms, which scare her
yet again, and she explains that she thinks he may have a relapse of his UTI. These symptoms
include a high fever (103.6F) and tachypnea, and upon pulmonary examination at your clinic,
you hear crackles, and find classic findings of lung consolidation.
What laboratory tests should you order, and what is your primary diagnosis at this point
and subsequent steps in his treatment and management?
Once explained, please indicate and describe your chosen pharmacological treatment
with inclusion of dose and mechanism of action of your chosen prescription.
This question was answered on: Sep 18, 2020
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