Question

11:03 LTE instructure-uploads.s3.amazc C Skin and wound case study Directions: Read the following case study and the accompanying questions. Using information from your textbooks or from reputable Intemet resources (such as cdc.gov), try to answer the questions as completely as possible. Follow the class guidelines for preparing and submitting your responses. You are observing an office visit as part of a clinical rotation in a rural health clinic. The patient is 53-year-old male farmer who has come in to see about a growth on his arm. About I week ago, he noticed some mildly itchy red bumps on his arm. They started to blister 1 or 2 days later and then ruptured. During this time he had a low-grade fever but otherwise felt well. Further questioning reveals that he has had no ill contacts and never had anything like this before. He has cows, horses, goats, sheep, and chickens on the farm. The physician who examines the farmer finds a 4.5 cm circular lesion on the patient's u very black and looks like a huge dark, crusty scab surrounded by vesicles and edema. The patient also has tender axillary lymph node enlargement. The physician points out the lesion to you and describes it as an eschar. The physician also obtains a sample of vesicle fluid and a biopsy from the eschar for lab analysis. pper right arm. The lesion is 1. Given the clinical picture, what is the name of disease you suspect? Justify your answer 2. If your diagnosis is correct, what is the causative organism? Give details about the microbe. 3. How did the farmer contract this infection? Is it contagious? 4. What treatment will be offered to the farmer? What is his 5. Can this disease be prevented? Explain.

Answer 1

1) From the given clinical picture the disease suspected is Anthrax. As Gram stain of fluid drained from a vesicle and a biopsy from the eschar both show chains of gram-positive bacilli on microscopy which is caused by in fection of anthrax; and also all the symptoms of the infected farmer shows that the suspected disease is Anthrax 2) Causative organism: Bacillus anthracis Bacillus anthracis is the etiologic agent of cutaneous, gastrointestinal, and inhalational anthrax. About 95% ofanthrax disease is cutaneous. B. anthracis is distributed worldwide, and all animals are vulnerable, but it is more prevailing in herbivores 3) As Infected animals usually develop a lethal infection and contaminate the soil and water w ith B. anthracis that can sporulate and continue to endure in the environment for many years. Oxygen is needed for sporulation while the spores will grow on culture plates, in soil or in the tissue of dead animals. In this case affected person is a farmer and is in contact with many kinds of animals, he might have acquired the disease by one of the mentioned ways. Human infections are caused by penetration of these spores through the skin barrier (cutaneous), assimilation of the spores (rare), or inhalation of the spores, which commonly occurs while dispensing animal yields. Person-to-person transmission of anthrax has not been described 4) Ciprofloxacin is the drug of choice for anthrax, following the identification of w eaponized strains that were resistant to penicillin as a result of the production of a P- lactamase. 5) Y es this disease can be prevented. Prevention of anthrax includes vaccination of animals as well as humans at high risk of contact (military personnel). Prophylaxis is not suggested for asymptomatic persons. When found necessary, prophylaxis with ciprofloxacin should be maintained for up to 30 days due to potential delay in germination of inhaled spores.