A 2-year-old female child presented to the emergency department with symptoms of fever and seizures. The following labor

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A 2 Year Old Female Child Presented To The Emergency Department With Symptoms Of Fever And Seizures The Following Labor 1 (82.19 KiB) Viewed 95 times

A 2-year-old female child presented to the emergency department with symptoms of fever and seizures. The following laboratory tests were ordered: CBC, basic metabolic panel, ASO, mononucleosis screen, urinalysis, and blood culture. The child also had a high WBC count (16.2 x 109 L) with a differential showing 75% neutrophils, 15% lymphocytes, and 10% monocytes. The ASO and mono screens were negative. A lumbar puncture was performed. The CSF was colorless but cloudy. The CSF cell count showed 460 WBC/mm3 with a distribution showing 10% neutrophils, 78% lymphocytes, and 12% mononuclear cells. The WBC and RBC normal reference counts on CSF were 0-5 cell/mm3. The CSF RBC was 12 RBC/mm3, glucose was 29 mg/dL (reference range 40 to 70 mg/dL), and protein was 260 mg/dL (reference range 15 to 60 mg/dL). A cryptococcal antigen test of CSF was negative. Additional tests were ordered on the CSF: they were bacterial culture, fungus culture, AFB culture, enterovirus by PCR and herpes simplex virus by PCR. 5. To expedite the process, the pediatrician ordered a direct DNA probe for M. tuberculosis complex on the broth sediment. M. tuberculosis was identified by direct probe. Susceptibilities were performed but those results were not available for an additional 3 weeks. What are the current recommendations for antimicrobial testing for this organism? 6. What are the laboratories responsibilities regarding reporting of this AFB culture to both the ordering physician and health department? IF