Correct!
2. Ciprofloxacin
Treatment is indicated for influenza A which is probably responsible for her acute respiratory failure. Oseltamivir was given. However, whether to treat the Pseudomonas and Aspergillus is not entirely clear. Both are common airway colonizers in the ICU. However, since the patient was acutely ill she was begun on both cefepime and voriconazole. If ciprofloxacin was used it is unclear what would be treated since the Pseudomonas is resistant and it is not a treatment for either influenza or Aspergillus.
The patient was improving and had been extubated but several days later developed hemoptysis. A repeat chest x-ray is shown in figure 2.
Figure 2. Repeat portable chest x-ray.
What should be done next? (Click on the correct answer to proceed to the next panel)