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?

Campylobacter jejuni requires which type of environment?

Which organism is NOT considered a zoonoses?

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?

The most common bacterial cause of urinary tract infections is:

Which of the following is NOT a key component of health care access as defined in the lecture?

Which housing design features pose safety risks for individuals with physical disabilities?

Collection of specimens for the culture of Neisseria gonorrhoeae require which conditions?

Which organism is considered an opportunistic pathogen?

Case Study 1: This 19-year-old student was in his usual state of health until the evening prior to admission, when he went to bed with a headache. He told his mother that he felt feverish, and on the following morning his mother found him in bed, moaning and lethargic. He was brought to the emergency room, where he appeared toxic and drowsy, but oriented. His temperature was 40C, his heart rate was 126/min., and his blood pressure was 100/60 mm Hg. He had an impressive purpuric rash (bruise-like), not blanching, most prominent on his trunk, legs and wrists. A gram stain of the material taken from one of the patient’s skin lesions showed gram-negative diplococci. His white blood cell count was 26,000/ml (high) with 25% band forms (high). The platelet count was 80,000/ml (low). Blood cultures were obtained and the patient was begun on intravenous Ceftriaxone. Blood cultures subsequently grew the organism seen on the gram stains of the lesions. Case Study 1 Question 1:  What is the most likely diagnosis for this patient?