A 3 yr old caucasian girl is brought to the ER because of severe cough with sputum, fever, and rapid breathing. The cough started 1 month ago with sputum and has become persistent. Her past medical history is significant for prolonged neonatal jaundice and 2-3 episodes of bronchiolitis at the age of six and twelve months. Temp is 101.8. Exam reveals tachypnea, nasal polyps and coarse breath sounds on auscultation. Pulse oximetry shows O2 saturation of 87%. Chest X-ray shows hyperinflation with patchy consolidations. She is below the 5th percentile for height and weight. Which of the following is the most appropriate next step in management?
A. IV ceftazidime with tobramycin
B. Histopathologic analysis of nasal polyps
C.Pilocarpine iontophoresis test
D. IV levofloxacin
Answer:A
A 3 yr old caucasian girl is brought to the ER because of severe cough with sputum, fever, and rapid breathing. The cough started 1 month ago with sputum and has become persistent. Her past medical history is significant for prolonged neonatal jaundice and 2-3 episodes of bronchiolitis at the age of six and twelve months. Temp is 101.8. Exam reveals tachypnea, nasal polyps and coarse breath sounds on auscultation. Pulse oximetry shows O2 saturation of 87%. Chest X-ray shows hyperinflation with patchy consolidations. She is below the 5th percentile for height and weight. Which of the following is the most appropriate next step in management?
A. IV ceftazidime with tobramycin B. Histopathologic analysis of nasal polyps C.Pilocarpine iontophoresis test D. IV levofloxacin