Which of the following drugs would be appropriate for this patient? - ProProfs Discuss
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Which of the following drugs would be appropriate for this patient?
A 30-year-old Filipino man, who is a lifelong resident of the San Joaquin Valley, California presented to the hospital with a 4-day history low-grade fever (99.8 F°), severe a headache, irritability, and fatigue. Physical examination showed stiff neck and Kerning’s sign. Microscopic analysis of the spinal fluid revealed spherules filled with endospores.



A. Flucytosine
B. Penicillin G
C. Gancyclovir
D. Amphotericin B
E. Gentamicin
F. Zidovudine

This question is part of block 15 pharm antifungal drugs

Asked by GRAY, Last updated: Sep 08, 2020

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1 Answer

John Smith

John Smith

John Smith
John Smith

Answered Sep 09, 2016

Amphotericin b-answer: d the signs and symptoms of the patient suggest the diagnosis of meningitis and the lab results confirms that tha man is suffering from meningeal coccidioidomycosis. the infection is caused by coccidioides immitis, a soil mold that lives in semiarid regions of the globe (southwestern usa, argentina, etc.). inhalation of the arthrospores leads to a primary infection that is asymptomatic in 60% of individuals. the others develop a flu-like self limited illness called valley fever or desert rheumatism. following inhalation the arthrospores forms spherules that contain endospores. in biologic specimens these spherules are diagnostic of coccidioides immitis infection. in less than 1% of individuals a secondary or disseminated infection evolves within a year after the primary one. this secondary infection is often life-threatening and can affect many tissues but the most frequent organs are the bone and joints, and the meninges. untreated meningitis is always fatal. coccidioides immitis is sensitive to amphotericin b and to antifungal azoles. amphotericin b is the drug of choice and is usually administered intrathecally in meningeal coccidioidomycosis, since the drug penetration into the cns is limited. a) flucytosine can easily enter the brain but is not effective against coccidioides immitis. b, c, e, f) these agents are not antifungal drugs.
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