An elderly male admitted for Pneumonia presents with diarrhea and gripping abdominal pain five days after discharge from the hospital. Drug which is likely to benefit is
Correct Answer: Levofloxacin
Description: Ans. is 'd' i.e., Levofloxacin Development of pneumonia and gastrointestinal symptoms (diarrhea & gripping abdominal pain) within 10 days after discharge from hospital hints to a possible diagnosis of Legionnaire's disease. The drugs of choice for legionnairs's disease include Azithromycin and Respiratory Fluoroquinolones such as levofloxacin, gatifloxacin, Gemifloxacin and Moxifloxacin It is a case of legionnaire's disease. Legionnaires disease usually presents as atypical pneumoniae. The unique feature of legionnaires disease is that the clinical manifestation of this disease are usually more severe than those of most atypical pneumonias and the course and prognosis of legionella pneumonia more closely resemble those of bacteremic pneumococcal pneumonia than those ofpneumonia due to other organisms Think about the diagnosis as legionaire's disease whenever the question talks about a pneumonia like picture along with any of the following - Gastrointestinal disturbances such as diarrhoea. Neurological abnormalities such as confusion and headache altered sensorium. High fever (> 40degC or > 104degF) Numerous neutrophils, but no organisms revealed by gram's staining of respiratory secretions. Failure to respond to $ lactam drugs (penicillins and cephalosporins) and aminoglycoside antibiotics. Hyponatremia (S.Na- < 131 meq/1) Elevation in liver function tests. Occurrence of illness in an environment in which the potable water supply is known to be contaminated with legionella. Onset of symptoms within 10 days of discharge from hospital. Occurence of illness in immunocompromised individual
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