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Imagine yourself as a clinical microbiologist with all ofthe
diagnostic tools described in this chapter available for your
analyses. Which tool(s) would you use (and why) if (1) A
patient had a life-threatening infection caused by adifficultto-
culture bacterium and where treatment of the infection
was absolutely dependent on an extremely rapid identification
of the pathogen? (2) A patient had a less severe
bacterial infection where the pathogen was easily culturable
and treatable?

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Beverley Smith
Beverley SmithLv2
28 Sep 2019

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Related questions

Case Study #1: A Common Opportunistic Infection

Ben, a seven-year-old second grader, quickly finished his homework after school so he could play outside with his friend form next door. Since Ben had started coughing the day before, his mother insisted he wear his jacket. At bedtime, Ben was exhausted from his busy day. When kissing his forehead goodnight, Ben’s mother noted that he felt a little warm. To help Ben sleep more comfortably since he was likely getting a cold, his mother gave him a dose of pediatric Tyenol, “Poor Ben,” she thought. “Three weeks ago he had the flu and now a cold is starting. He could really use a break.”

In the morning, Ben didn’t come to the breakfast table when called. His mother found Ben still in bed, barely responsive, and extremely feverish. She immediately drove him to the walk-in clinic in their neighborhood. Ben’s oral temperature was 40.8C (105.4F). IV fluids were started and an ambulance transported Ben to the nearest hospital.

In the hospital emergency room, Ben presented with the following viral signs: temperature = 41.9C (107.4F), pulse = 162 bpm, pulse ox = 90%, respirations = 24/minutes and labored, BP = 62/54 mmHg. Ben was completely unresponsive. His physical exam was remarkable for rales or “crackles” heard over both right and left lower lung fields. Bilateral chest radiographs were ordered and revealed infiltrates in the lower lobes of both lungs.

Preliminary lab results yielded a white blood cell count of 16,200 cells/mm^3 and a differential count with 74% neutrophils, including 18% bands. Respiratory acidosis was indicated by an arterial blood pH of 7.2. These results were immediately called from Ben’s local hospital to his new facility and broad-spectrum IV antibiotic therapy was initiated.

9. Approximately 6 hours later, the clinical microbiologist examined the BAP and chocolate agar plates. What morphological features did she likely observe on the plates? Why were these two media types selected for culturing?

10. What results would you predict from the following tests?

Optochin

Catalase

Bacitracin

Bile solubility

Quellung reaction

11. What is the significance of the following laboratory results?

The WBC

High neutrophil count with elevated bands

Respiratory acidosis

Automated identification and sensitivity testing were initiated and the presumptive microbe identification called to the other facility to aid in treatment. Ben’s attending physician was relieved to find that the CSF was sterile, as she had just initiated prophylactic antibiotic treatment of Ben’s caregivers. Unfortunately, she reported that Ben’s condition had continued to decline and he has been pronounced dead earlier that hour. She requested that identification/sensitivity data be forwarded upon completion so Ben’s record could be finalized.

12. Why was Ben’s physician relieved that the CSF was sterile? What possible infection was she considering?

13. Assuming Ben was receiving broad-spectrum IV antibiotic therapy that was effective against his infection, what reasons can you give to explain his rapid deterioration and eventual death when receiving an appropriate empiric therapy?

Within 6 hours, the Virek analyzer confirmed the identity of this microbe and indicated its sensitivity to penicillin, cephalosporins, and fluoroquinolones. While Ben’s attending physician was pleased that her staff had not been exposed to a resistant microbe, she was frustrated to have lost a young patient to one so sensitive to standard antibiotics.

14. Were there any predisposing factors that put Ben at greater risk for this infection?

Provides substantial and thoughtful response, reflection – in-depth and detailed for the following post. Please don't copy past from the web

Mumps was common in World War I many troop members caught this infectious disease which leads them to hospitalization. It is also important to remember that even those who are vaccinated are still at risk for developing mumps. Mumps is a highly contagious viral disease that has continued to spread globally. This viral infection affects the parotid glands which produces saliva and are located below and in front of your ears. If you or your child develops Mumps, it can cause swelling of one or both parotid glands. Mumps outbreaks were extremely common in the United States until vaccination became routine. Since then the number of cases has dropped significantly in the United States but is still a problem in other regions of the world.

Mumps is rarely life threatening illness, but it can cause a serious discomfort in those infected. The swelling of the parotid gland lasts over a week, and it can affect feeling in the jaw. Orchitis, or inflammation of one or both testicles, is commonly seen in male patients who have reached puberty but rarely causes sterility. Low-grade fevers, headaches, and general malaise are common complaints, with a small percentage of patients displaying symptoms of viral meningitis. Rare cases of mumps can cause infection of the brain, and inflammation of the covering of the brain and spinal cord. Other complications also include arthritis, kidney and pancreases problems, deafness, and inflammation of the ovaries.

Although there is no specific treatment for mumps, it can be prevented with the vaccine. The vaccine after exposure has not been found to be protective. However, only 120 countries have the vaccine for Mumps, and that leaves countries without it suffering and could lead to serious health problems. One country that does not have this vaccine is India, and there has been a rapid growth in Mumps over the years, and it is mainly affecting children. Mumps outbreaks or sporadic cases have been periodically reported from the States of Kerala, Maharashtra, Gujarat, Karnataka, Punjab, Tamil Nadu, Uttar Pradesh and West Bengal. India is very limited on information and data regarding mumps. The cost of the vaccine for India would offset the burden of this infectious disease.

China is one country that has a vaccination for mumps this came out in 2008 since then mumps have decreased. Except 2013-2015 a natural epidemic pattern of mumps has slightly changed making the vaccine less affective than before. During this period studies showed that mumps had decreased among teens/children and had increased in adults. These recent outbreaks have caused wide concerns regarding the vaccine and how affective it is.

In conclusion, mumps is a disease that has been around for decades. It also has the potential to have sporadic outbreaks, and it mainly affects children. In the emerging world, not all vaccines work because our bodies get used to the disease and also it can change naturally during the time. With the progression of modern technology, we can only hope that we find a way to prevent mumps altogether. Mumps is not the most serious disease, but it can cause pain and has the potential to be extremely dangerous.

Citations:

Burnett, M. (2017). An ongoing series.

Paul, S. (2017). Investigating Mumps Outbreak in Odisha, India: An Opportunity to Assess the Health System by Utilizing the Essential Public Health Services Framework.

A. C. (2017). Mumps Epidemiology and Mumps Virus Genotypes Circulating in Mainland China during 2013-2015.

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