Question

Caleb Bakersfield, a 42-year-old real estate agent, had just returned from a vacation to Russia. His childhood had been rough because of an alcoholic and abusive father, and Caleb had started his own drug addiction in his early teens. By his early twenties, he was addicted to heroin, lived on the streets, and frequently used dirty needles. In his thirties, Caleb joined a program to beat his addiction and to turn his life around. The trip to Russia was to celebrate a decade of being clean.

Less than two months after his trip, Caleb started having respiratory complications, including a frequent cough and shortness of breath. He figured it was most likely a respiratory infection and made an appointment with his physician.

After listening to Caleb’s lungs, Dr. Bell determines that Caleb most likely has a lower respiratory infection and prescribes the antibiotic azithromycin. Dr. Bell reminds Caleb that it is important to complete his entire course of antibiotics, even if he feels better before he finishes all of the medicine. Dr. Bell also collects a sputum sample (mucus coughed up from the lower respiratory tract) and sends it to the laboratory for evaluation.

Answer 1

The Azithromycin is a broad spectrum antibiotic and it was given to Caleb assuming that it is going to subside the infection of the lower respiratory tract. However, with the mucus test, if the lower respiratory infection does not cure and the cough gets worst, he needs to undergo couple of additional sputum and blood tests. It is mostly likely that he is suffering from tuberculosis leading to the cough. As he used a lot of needles in his younger days, it is mostly likely that his blood reports show him HIV positive. The dirty needle is the main cause of HIV and leading to his weakened immune system. The weak immune system is mostly probably not able to produce enough immune cells to fight the M.Tuberculosis pathogen or bacteria due to which his coughing is likely to increase. If he is suffering from HIV, it is important to start treatment the therapy with help of anti-retroviral drugs, nucleotide analogs and other new HIV drugs.