Question

Using the following case study, answer the accompanying questions. A 9-year-old girl presented with low-grade fever, sore throat, and malaise for 2 days. These symptoms developed 10 days after arriving at a summer camp. Recently, she was noted to have a dry cough and difficulty breathing. The girl's family had emigrated from Eastern Europe one year before. The child's immunization status could not be determined. What bacteria could cause these signs and symptoms? Upon physical examination, you notice the patient had exudative pharyngitis and a yellowish, leathery thick membrane covered the uvula and soft palate. What is the likely causative agent? How would you treat?

Answer 1

The bacteria causing the signs and symptoms of low-grade fever, sore throat, and fatigue for two days together with dry cough and difficulty breathing is Corynebacterium diphtheriae. The yellowish leathery thick membrane covering uvula and soft palate with exudative pharyngitis is caused by Corynebacterium diphtheriae. This disease is still present in parts of Eastern Europe and the reason could be due to poor immunization coverage. In this case, the 9-year-old girl's immunization status is unknown and she is from Eastern Europe. The causative agent is Corynebacterium species. The effective treatment would be to treat with an antibiotic like penicillin or erythromycin and an antitoxin. The antitoxin is given after performing the skin allergy test to ensure that the patient does not have any allergy to the antitoxin. If she has an allergy, she will be desensitized by giving small initial doses and then gradually increasing the dose.