Question

Date: Take Home Exam il Chapters 5, 6,9 & 10 cs 2 -A lethargic 22-month old black female was presented by her mother to the emergency room at 2:15am on a Sunday. The child had a history of a runny nose, hoarse cough and low-grade fever (-99F) for the past 48 hours. The mother was concened about the forced and noisy breathing of the child. The pediatrician examined the child and found cloudy eyes and mild inflammation of the ears, but no overt signs of bacterial infection (no significant changes in the eardrums). The throat of the child was red and coated with mucus. The larynx was swollen and raw. The physician performed a rapid Strep Test. and found it was negative. Throat swabs were taken for culture. The physician placed the child in a room with a warm vaporizer for about 30 minutes. This dramatically improved the breathing of the child. rapid Strep test is used in the diagnosis of bacterial pharyngitis caused by groupA streptococci (GAS), sometimes termed strep throat. 1. What is the presumptive diagnosis for this case? Will the throat cultures likely show evidence of Streptococcus pyogenes? How about Staphylococcus aureus? 2. 3. Do you believe that this is a bacterial or viral disease? Why? 4. What further treatment might be indicated for this case? Microbiology (Bio175) Dr. V.

Answer 1

CS 2

1. ANS: adenoviral pharyngitis, croup is the presumptive diagnosis for this case

2. ANS: No, the throat cultures likely not shown any evidence of Streptococcus pyogenes and the Strep test was negative and the overall picture indicates a viral infection

3. ANS: It is a viral disease; little or no pus on pharynx, good response to warm vapor to clear congestion.

4. ANS: Further treatment: Analgesic, decongestant, and more vapor treatment, antibiotics should be reserved unless Strep of Hib shows on culture.

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