Case Study “Big Woop” HBS Israel Bermudez Aleysjah Crabbe Pilar Grange Shaharia Jenkins

The story… Tasha, a 17 year old irresponsible mother of a five month old baby named Jamie. Tasha has had symptoms of a common cold for about a week and a half. Two and a half weeks later….

Patient - Jamie Brown Tasha Brown reported her five month old baby Jamie Browns symptoms of –Runny nose –Slight fever –Diarrhea To the in-nurse at Jamie’s day care center at The Women’s League.

Exam at the Women's League Jamie has not been given any medicine to calm her cold Physical exam Medical history shows no results of any complications Patient has no allergies Mothers’ history shows complications during birth and recently had the flu. Patient meds- none

Results The nurse informed Tasha that her baby has a common cold and not to worry. She also informed her that Jamie should be given 2.5 mL of Tylenol orally every 6-8 hours

Pediatrician P.E.D Study medicine and biochemistry and anatomy. 3-8 years of internships and residence working in hospitals or clinics. Primary care is to care for infants and children until the age of 18.

Exam Vital signs Height: 21’’Wt: 16 lbs. 5 oz. T:37.9 ° C PR:120 to170 Palpitation is normal Reflexes in bilateral in upper and lower extremities and muscle strength is normal. Lungs sound is a bit abnormal because of the mucus. DX: Common cold Rx: Motrin for the next week to treat the fever. Return in two weeks for check-up.

Patients in Crisis After 6 days the mother notice that her child's fever was getting worse and her breathing and coughing became heavier and had a distinct sound to it. Tasha’s mother rushed Tasha and Jamie to the hospital.

Patient is admitted to the hospital Questioning by hospital staff included concerns about the mothers health history, daily routines, and Jamie’s health and where-about. Tasha recalls having a severe common cold about a month ago but never went to the doctor/hospital. Recommended to a more experienced physician

Attending Hospital Physician Doctor of medicine – M.D Doctor of Osteopathy – D.O Associate degree in respiratory therapy

Patient is stabilized Thorough physical exam Throat and nose mucus samples shows a great number of mucus Blood test shows high white blood cell count A chest x-ray was ordered – results show presence of inflammation and fluid in the lungs

Bacterial Infection Bordetella pertussis

Pertussis Symptoms: Catarrhal Stage (lasts 1-2 weeks) Runny nose, sneezing, low fever, mild cough Paroxysmal Stage (after 2 more weeks, lasts weeks) Bursts of coughing, sometimes rapid, followed by a long, deep, high pitched respiration Ill appearance Vomiting Convalescent Stage (recovery stage) Gradual recovery

Complication Can cause pneumonia and convulsions Extreme leukocytosis in fatal cases (high number of WBCs)

Final Treatment Baby will be hospitalized until signs of progression Given antibiotics for next two weeks Suctioned of thick respiratory secretions. Breathing will be monitored and oxygen will be given Given IV for dehydration due to poor oral intake Tylenol and Motrin given to treat fever

Prognosis Neither Tasha nor Jamie were vaccinated 1 in 100 affected infants die Unfortunately, Jamie succumbed to pneumonia while under hospital care and died Semptember 19, 2011

Sources "CDC - Pertussis: Clinical." Centers for Disease Control and Prevention. N.p., n.d. Web. 3 June "Pertussis - PubMed Health." National Center for Biotechnology Information. N.p., n.d. Web. 2 June "Whooping Cough (Pertussis)." KidsHealth - the Web's most visited site about children's health. N.p., n.d. Web. 3 June "Pertussis - Wikipedia, the free encyclopedia." Wikipedia, the free encyclopedia. N.p., n.d. Web. 3 June "PERTUSSIS." Illinois Department of Public Health Home Page. N.p., n.d. Web. 4 June "Pertussis: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. N.p., n.d. Web. 4 June "CDC - Pertussis: Diagnosis and Treatment." Centers for Disease Control and Prevention. N.p., n.d. Web. 4 June "pertussis (whooping cough) - Prognosis." Free Diet Plans at SparkPeople. N.p., n.d. Web. 4 June

Sources "Whooping Cough (Pertussis) Treatment, Prognosis - Whooping Cough (Pertussis) - HealthCommunities.com." Health Information and Tools - HealthCommunities.com. N.p., n.d. Web. 4 June "CDC - Pertussis: Complications." Centers for Disease Control and Prevention. N.p., n.d. Web. 5 June "Pertussis in Young Infants." AAP-CA: Home Page. N.p., n.d. Web. 5 June