I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
Monday, April 30, 2012
A 90 year old man with HTN, HL, a-fib, COPD, kidney stones, BPH, GERD, osteoarthritis, h/o GI bleed, gout, and dementia is admitted from the nursing facility where he lives to the hospital because of shortness of breath and cough. CXR shows a lobar pneumonia. Sputum induction grows MRSA. He gets severe red man syndrome with vancomycin so he is started on the drug shown above by the resident. This cyclic lipopeptide depolarizes the bacterial cell membrane and is approved for skin and soft tissue infections as well as bacteremia with MRSA. The resident remembers to write for weekly CKs and to check for peripheral neuropathy and myopathy.
Challenge: However, this patient won't get better. Why? What's the mechanism?
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