A 4-year-old was bitten on her hand by her pet cat. Two days…
A 4-year-old was bitten on her hand by her pet cat. Two days later, the bite area was swollen and had some drainage. A Gram’s stain of the pus revealed small gram-negative coccobacilli. The most likely identity of this organism is:
Read DetailsCase Study 2: This 63-year-old alcoholic was taken to the e…
Case Study 2: This 63-year-old alcoholic was taken to the emergency room of an outside hospital with obvious gangrene of both feet. He was stuporous. During that evening, he had a seizure and was treated with phenytoin and barbiturates. By the night of transfer he was noted to have opisthotonic posturing and to have developed increasing respiratory distress and unresponsiveness. On examination, he had a temperature of 41.7°C rectally, a blood pressure of 70/30 mmHg, a heart rate of 110 beats/min, and a respiratory rate of 40/min. Examination was notable for marked trismus. The neck was stiff and hyperextended. Necrotic, blackened areas were present over both feet and several draining ulcers were noted on the heels and toes. Neurologically the patient responded to deep pain with a grimace. On the basis of these findings, specific therapy, in addition to supportive care, was initiated, and the patient ultimately recovered. Case Study 2.3: What was the specific therapy used to treat this secondary infection?
Read DetailsCase Study 2: An 85-year-old male is admitted to the emerg…
Case Study 2: An 85-year-old male is admitted to the emergency room of a New York City hospital suffering from breathing difficulties and coughing. He had a high fever, cough, and chest pain. He had presented to his local physician 3 days previously complaining of fever, headache, malaise, and vague respiratory symptoms. A year ago he moved into a long-term care facility after his wife died and he has been suffering from Type 2 diabetes for the last thirty years. They collected sputum for culture and sensitivity. A gram stain indicated the presence of many white blood cells and pleomorphic gram-negative coccobacilli. An additional urine specimen was then collected and sent to a reference laboratory to confirm the diagnosis. Case Study 2 Question 1: What was the most likely etiologic agent of infection in this patient?
Read DetailsCase Study 4: An 8-year-old female was brought to the walk…
Case Study 4: An 8-year-old female was brought to the walk-in clinic by her mother. For the last three days she has been complaining that her ear has been bothering her and last night she developed a low fever. Her vaccinations are all up to date, her medical history is unremarkable, and she has had no previous illness; she is a healthy girl. Her mother mentions that she is very active in sports, alternating between swimming and soccer competitions every weekend. The physician collected a culture and stat gram stain of the outer ear canal. The gram stain showed many white blood cells and gram-negative bacilli. The physician then gave the girl antibiotic drops to use twice a day for seven days without waiting for the culture results. Case Study 4 Question 3: What was the likely source of the infection?
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