Case Study

“Big Woop”

HBSIsrael BermudezAleysjah Crabbe

Pilar GrangeShaharia Jenkins

The story…

Tasha, a 17 year old irresponsible mother of a five month old baby named Jamie. Tasha has had symptoms of a common cold for about a week and a half.

Two and a half weeks later….

Patient - Jamie Brown

Tasha Brown reported her five month old baby Jamie Browns symptoms of

– Runny nose– Slight fever– Diarrhea

To the in-nurse at Jamie’s day care center at The Women’s League.

Exam at the Women's League

Jamie has not been given any medicine to calm her coldPhysical examMedical history shows no results of any complications Patient has no allergiesMothers’ history shows complications during birth and recently had the flu.Patient meds- none

Results

The nurse informed Tasha that her baby has a common cold and not to worry.

She also informed her that Jamie should be given 2.5 mL of Tylenol orally every 6-8 hours

Pediatrician

P.E.D

Study medicine and biochemistry and anatomy.

3-8 years of internships and residence working in hospitals or clinics.

Primary care is to care for infants and children until the age of 18.

ExamVital signs

Height: 21’’Wt: 16 lbs. 5 oz. T:37.9°C PR:120 to170

Palpitation is normal

Reflexes in bilateral in upper and lower extremities and muscle strength is normal.

Lungs sound is a bit abnormal because of the mucus.

DX: Common cold

Rx: Motrin for the next week to treat the fever. Return in two weeks for check-up.

Patients in Crisis

After 6 days the mother notice that her child's fever was getting worse and her breathing and coughing became heavier and had a distinct sound to it.

Tasha’s mother rushed Tasha and Jamie to the hospital.

Patient is admitted to the hospital

Questioning by hospital staff included concerns about the mothers health history, daily routines, and Jamie’s health and where-about.Tasha recalls having a severe common cold about a month ago but never went to the doctor/hospital.Recommended to a more experienced physician

Attending Hospital Physician

Doctor of medicine – M.D

Doctor of Osteopathy – D.O

Associate degree in respiratory therapy

Patient is stabilized

Thorough physical exam

Throat and nose mucus samples shows a great number of mucus

Blood test shows high white blood cell count

A chest x-ray was ordered – results show presence of inflammation and fluid in the lungs

Bacterial Infection

Bordetella pertussis

http://microblog.me.uk/wp-content/uploads/bordetella_pertussis_r.1.jpg

Pertussis

Symptoms:Catarrhal Stage (lasts 1-2 weeks)

Runny nose, sneezing, low fever, mild cough

Paroxysmal Stage (after 2 more weeks, lasts 1-10 weeks)

Bursts of coughing, sometimes rapid, followed by a long, deep, high pitched respiration

Ill appearance

Vomiting

Convalescent Stage (recovery stage)Gradual recovery

Complication

Can cause pneumonia and convulsions

Extreme leukocytosis in fatal cases (high number of WBCs)

http://www.safehealthmedicine.net/images/pneumonia%20image.jpg

Final TreatmentBaby will be hospitalized until signs of progression

Given antibiotics for next two weeks

Suctioned of thick respiratory secretions.

Breathing will be monitored and oxygen will be given

Given IV for dehydration due to poor oral intake

Tylenol and Motrin given to treat fever

PrognosisNeither Tasha nor Jamie were vaccinated

1 in 100 affected infants die

Unfortunately, Jamie succumbed to pneumonia while under hospital care and died Semptember 19, 2011

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"Pertussis - Wikipedia, the free encyclopedia." Wikipedia, the free encyclopedia. N.p., n.d. Web. 3 June 2012. <http://en.wikipedia.org/wiki/Pertussis>.

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"pertussis (whooping cough) - Prognosis." Free Diet Plans at SparkPeople. N.p., n.d. Web. 4 June 2012. <http://www.sparkpeople.com/resource/health_a-z_detail.asp?AZ=623&Page=8>.

Sources"Whooping Cough (Pertussis) Treatment, Prognosis - Whooping Cough (Pertussis) - HealthCommunities.com." Health Information and Tools - HealthCommunities.com. N.p., n.d. Web. 4 June 2012. <http://www.healthcommunities.com/whooping-cough-pertussis/children/whooping-cough-treatment-prognosis.shtml>.

"CDC - Pertussis: Complications." Centers for Disease Control and Prevention. N.p., n.d. Web. 5 June 2012. <http://www.cdc.gov/pertussis/about/complications.html>.

"Pertussis in Young Infants." AAP-CA: Home Page. N.p., n.d. Web. 5 June 2012. <http://www.aap-ca.org/clinical/pertussis/pertussis_in_young_infants.html>.