Question

A 38-year-old woman presents with a 2-week history of sore throat and fever; symptoms have been unresponsive to over-the-counter medications. On exam, the patient appears ill. Her temperature is 39 C; Her pharynx is red and injected; you notice painful aphthous ulcers in her mouth. Complete blood count reveals a WBC of 1.60 X 109/L; differential shows 0.5% neutrophils. Hemoglobin is 9.5 g/dL. Urine dipstick shows proteinuria. Blood cultures and other analyses are pending.

Question:
You immediately admit the patient and order aggressive volume replacement, filgrastim, and what additional treatment?

Answer 1

The additional treatment that should be ordered for the patient is intravenous immunoglobulin (IVIG) therapy, which can help correct immune-mediated complications. Aggressive volume replacement and filgrastim are important in the management of the patient's symptoms and underlying condition.

Step-by-step explanation:

The additional treatment that should be ordered for the patient is intravenous immunoglobulin (IVIG) therapy. In the case described, the patient presents with a sore throat, fever, and painful aphthous ulcers in her mouth. The low white blood cell count and proteinuria suggest a possible viral infection such as viral pharyngitis with associated immune-mediated complications like immune thrombocytopenic purpura (ITP).

Intravenous immunoglobulin (IVIG) therapy involves infusion of a solution containing antibodies derived from pooled human plasma. IVIG therapy can help correct immune-mediated complications by providing a temporary boost to the immune system. It is often used in the management of various autoimmune and immune-mediated conditions such as ITP.

Aggressive volume replacement and filgrastim are important in the management of the patient's symptoms and underlying condition but IVIG therapy specifically targets the immune-mediated complications that the patient is experiencing.