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Question: Michael Myers was born after 38 weeks’ gestation. He remained in the nursery for 3 days, with no …

Question: Michael Myers was born after 38 weeks' gestation. He remained in the nursery for 3 days, with no ...

Michael Myers was born after 38 weeks’ gestation. He remained in the nursery for 3 days, with no complications. After the 3 days, he was discharged and sent home. Alter 2 weeks, during which he fed and grew well, his mother noticed a slight redness around the stump of his umbilical cord. She didn’t think much of It at first but after 24 hours the redness had spread and the umbilical area had become hard and swollen. Michael became irritable, refused to eat, and developed a fever (38.7 degree C). His mother took him to the pediatrician, who diagnosed Michael with an infection of the umbilical stump and referred him for treatment at the nearest emergency room. On arrival, Michael was lethargic. His temperature was 40.2 degree C and his heart rate was above 180 beats per minute. His breathing was fast and shallow and his blood pressure was low. The emergency room team immediately treated Michael with fluids and broad-spectrum antibiotics. A complete blood count was also performed and revealed severe neutropenia (severely reduced number of neutrophils). The antibiotics resolved the infection overall: however, his neutrophil count remained low and the physicians wondered if the neutropenia was a result of the microbes targeting the neutrophils, or if the neutropenia was a result of congenital neutropenia. The physicians treated Michael with recombinant human granulocyte colony-stimulating factor (G-CSF), a cytokine that typically results in the development and differentiation of neutrophils. As a result of the G-CSF treatment. Michael’s neutrophil count increased and he fully cleared the bacterial infection. Upon resolution of the infection, the G-CSF treatment was ended. Michael’s neutrophil count once again became reduced. Is the neutropenia a congenital effect? Or, is it from the bacterial presence? What aspects of the case study made you come to this conclusion? Is it normal to observe a severely reduced number of neutrophils during the initial stages of a bacterial infection? How are neutrophils beneficial in immune response? Michael responded to the G-CSF treatment: however, following its end, he reverted to the low level of neutrophils. What does this mean for the future treatments of Michael?

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