A 65-Year-Old Man Comes to the Emergency Department Due to Fevers

question 503

Multiple Choice

A 65-year-old man comes to the emergency department due to fevers, chills, and confusion.  He has a history of poorly controlled diabetes mellitus with a nonhealing ulcer of the left foot.  His temperature is 38.3 C (101 F) , blood pressure is 90/60 mm Hg, pulse is 112/min, and respirations are 22/min.  On examination, there is slight erythema surrounding his left foot ulcer with foul-smelling discharge.  No heart murmur is auscultated, the lungs are clear, and the abdomen is soft and nontender.  Blood cultures are obtained, and he is started on broad-spectrum antibiotics.  Twenty-four hours later, blood cultures grow β-lactamase-producing Bacteroides species.  Which of the following is most likely to provide appropriate antimicrobial coverage for this patient?

• A)Azithromycin
• B)Ceftriaxone
• C)Ciprofloxacin
• D)Piperacillin-tazobactam
• E)Vancomycin

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Definitions:

Repressor

A substance, often a protein, that inhibits the expression of a gene.

Differentiated Cell

A cell that has developed and specialized to perform a specific function in the body.

Genes

Sequences of DNA that contain the instructions to build and maintain an organism's cells and pass traits to offspring.