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From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: A Question
Date: 11 Jan 2000 09:34:30 GMT

In <A2262F2FEC148570.C7FB257F549A356F.D9BD0DC7539CBCAD@lp.airnews.net>
jrfox@no.spam.fastlane.net.no.spam (Jonathan R. Fox) writes:

>On 11 Jan 2000 03:12:26 GMT, gcramps@aol.com (GCramps) wrote:
>
>>I have a 14 yro child with an infection of the lymph node in the arm pit
>>(wbc around 18000). Pretty serious since it was accompanied with a 103
>>degree F fever. The diagnoisis was Cissilatus (SP?). The redness spread
>>close to the elbow while under a treatment of cephallexin (500mg). Upon
>>subsequent evaluation, the treatment was changed to dicloxacillin
>>(500mg). The redness and infection seems to be responding to
>>dicloxacillin; while it was not to the cephallexin. The question is:
>>What is the difference between the 2 antibiotics?
>
>I think you meant cellulitis.  It is usually caused by bacteria,
>either streptococci or staphylococci.  Cephalexin is useful against
>both, whereas dicloxacillin is more of an anti-staphylococcal agent.
>Did the fever go away while on the first medicine?  With some forms of
>cellulitis, the redness will continue to spread for a few days even
>though the antibiotic is working.  If the fever was gone and her
>tenderness improved, perhaps the change in antibiotic was not
>necessary.
>
>--
>Jonathan R. Fox, M.D.



   Is the child diabetic?  This is a rather weird thing to be happening
to a 14 year old otherwise health kid, and unless there's something
we're not hearing about, somebody should do a complete checkup on him
or her when the infection is cleared up.

    I'm rather amazed that a child with cellulitis, fever, and high WBC
count (I assume bandemia) wasn't hospitalized for at least the
beginnings of IV antibiotic therapy.  It would certainly be grounds for
such in my book.   (Given bandemia-- I'm not talking about a skin
infection in a febrile child who appears also to have a viral URI,
looks well, has no left shift, etc, etc).  However, if this is what is
advertised, no insurance company or government agency would disagree
with me about the IV stuff.  Good Heavens-- where (geographically) was
this case?



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