Question

A 24-year-old female was hospitalized with a three week history of fever, chills, night sweats and generalized abdominal and low back pain. One week prior to admission, she had had bitemporal headache, dark urine and watery diarrhea. Three days before, she had been examined in the emergency room of the hospital; her hematocrit was 32, and her WBC count was 4900 with atypical lymphocytes. On admission, she had tachycardia and a rectal temperature of 40.9 C; other physical findings included a soft systolic murmur at the cardiac base, mild lower quadrant abdominal tenderness, hepatosplenomegaly, and bilateral costovertebral angle tenderness. Her hematocrit was 28 and hemoglobin was 8.4 g per 100 ml, and she had evidence of disseminated intravascular coagulation without bleeding. Liver function tests and electrolytes were normal; her white blood cell count was 2700. A month later the sister of this patient was admitted to the same hospital and gave a two week history of head cold and fever. The week prior to admission, she had experienced a dry, nonproductive cough, bitemporal headache, nausea, vomiting, and mild generalized arthralgia; she had also occasional night sweats, fever, and chills. On admission, her temperature was 38.6 C orally, and her pulse rate was 120 per minute. Epidemiological investigation revealed that the mother-in-law of the second patient had purchases goat cheese at a market in Juarez, Mexico, and that this cheese had subsequently been eaten by several members of the family. Both sisters gave a history of eating the cheese.

What is the microbe?

Answer 1

Cheese is the highly nutritious medium for growth of microbes and can support the growth of many pathogenic microorganisms. It can be responsible for many outbreaks of food poisoning and infections.

The main microbes that are associated with food poisoning outbreaks caused by the cheese includes Salmonella spp., Staphylococcus aureus, Listeria monocytogens, and enteropathogenic strains of Escherichia coli.

Reason for the cheese related infection may be due to poor starter activity due to bacteriophage or presence of antibiotic, poor hygiene or faulty pasteurisation of cheese milk.