Question

5:18 CASE STUDY 5.2 Jamie is a 48-year-old black woman who comes into the emergency department complaining of painful swelling, drainage, and redness over the past 5 days in the left hand. She spends a lot of time outdoors working in her garden and said she had a "ret nasty mosquito bite on the top of that hand befe the swelling started. After 3 days of increased swell ing and redness, she went to her doctor and receive an oral antibiotic and was told it was probably mild infection from the insect bite. Now, she presente because her hand is increasingly painful, tight, and the drainage has worsened. She noticed that she had a fever this morning of 102.9°F. Laboratory test re- sults today show a WBC count of 18,500. After intra- venous antibiotic treatment and hospitalization, the wound culture is found to be positive for methicillin- resistant S. aureus (MRSA). From your reading and experience regarding infectious processes, answer the following questions: 1. Outline the process that is most likely occurring in Jamie's body. 2. What is the probable source of this infection? 3. What would you expect for local and systemic clinical manifestations? 4. What diagnostic tests were used or could be used? How could you differentiate between viral or bac- terial pathogens? 5. What additional treatment measures would you anticipate? How is MRSA treated differently than nonresistant pathogens? 6. What would be the potential complications Log on to the Internet. Search for a relevant journa article or Web site that details MRSA and cont your predictions.
answer questions 4-6

Answer 1

4. Newer technique that measures staph DNA is available which detect within few hours.

From the medical history and reported symptoms, physician can identify the bacterial or viral origin. Also samples such as blood, sputum, CSF can be sent to Laboratory for pathogen identification. If any organism is found treatment can be given using antibiotic. If no organism is found the reason could be viruses.

5. Treatment for MRSA includes

Trimethoprin, sulfamethoxazole , clindamycin, tetracycline and others. taken orally. if infection is severe IV line can be given using the above antibiotics

sometimes simple opening the lesion and drainage of pus can give a cure.

This is contagious so the patient need to isolated such as covering the wound etc. Decolonisation to be done for nasal and topical areas for other close contacts. Antibiotic therapy must be completed fully to avoid recurrence of infection.

6. complications include Pneumonia, osteomyelitis, endocarditis, sepsis, blood stream infections, recurrent skin and soft tissue infections, septic arthritis, meningitis, epidural abscess,