Difficulty to confirm the diagnosis by culture: empiric antibiotic treatment should be started immediately due to the high complication and fatality<unk> e.
Adults
IV penicillin G: 200,000 units q4 hours for 5–7 days (can be switched to PO once patient shows clinical improvement)
PO penicillin V: 500mg QID, to complete a 14-day treatment course
Doxycycline (for PCN-allergic patients): IV or PO 100mg BID for 14 days
Pediatrics
IV penicillin G: 100,000–150,000 units/kg/day, divided in 4 doses, up to maximum 8 million units/day, for 5–7 days (can be switched to PO once patient shows clinical improvement)
PO penicillin V: 25–50mg/kg/day, divided in 4 doses, up to maximum 2g/day, to complete a 14-day treatment course
Doxycycline (for PCN-allergic patients): 2–4mg/kg/day IV or PO, divided in 2 doses, for 14 days
IV penicillin G: 200,000 units q4 hours for 5–7 days (can be switched to PO once patient shows clinical improvement)
PO penicillin V: 500mg QID, to complete a 14-day treatment course
Doxycycline (for PCN-allergic patients): IV or PO 100mg BID for 14 days
IV penicillin G: 100,000–150,000 units/kg/day, divided in 4 doses, up to maximum 8 million units/day, for 5–7 days (can be switched to PO once patient shows clinical improvement)
PO penicillin V: 25–50mg/kg/day, divided in 4 doses, up to maximum 2g/day, to complete a 14-day treatment course
Doxycycline (for PCN-allergic patients): 2–4mg/kg/day IV or PO, divided in 2 doses, for 14 days
Rat bite fever
Viral Infections
Metal fume fever
Palms/soles rash:
Scabies
Meningococcemia/Neisseria meningitidis
Rabies
Rocky mountain spotted fever