Question

Trouble Is Afoot Josh's favorite times of the year were summer and fall. Not because of humid heat or autumn's blazing color, but for the sports! Josh was a thr athlete. He seamlessly transitioned from summer swim league through basebal in each sport. This was an especially impressive accomplishment for a boy diag his and into football. Josh was not only a versatile athlete, but he also tru nosed with Type I diabetes at age seven. Now, a 17-year-old high school seni days as a star athlete were already over...Dr. Larkin had just removed most of Type I diabetes-Also known as nsulin-dependent diabetes or juvenile diabetes this chronic condition results from autoimmune damage to the pancreas, causing little to no insulin production. Since insulin is a hormone needed to facilitate glucose transport into cells for conversion into energy. t must be supplied exogenously to these left heel and sent it to the microbiology laboratory for culture. Josh thought back over the last several years and was suddenly even more depressed, as he rea this was his own fault. Ten years ago, within a month of diagnosis with diabetes, Josh's blood sugat levels were well-regulated. He and his family worked hard to learn a new lifestyk of counting carbohydrates and adjusting insulin levels. By the time Josh was 12, variable Dr. Larkin felt Josh was mature enough to use a pump. Josh was thrilled:w a pump it was so much easier to regulate his disease, especially with his varia Debriding-The removal of dead contaminated, or adherent tissue from a wound to eliminate infection and promote healing This may be done enyzmatically or surgically exertion levels during sports seasons. For the first year,Josh "played by the rules. But as he got older and his parents let him assume more responsibility for the management of his diabetes, Josh began taking advantage of this newfound free dom. When the gang went out for treats after the game, Josh indulged and simply used his pump to accommodate the added sugar load. And that was just the beginning. Josh knew diabetics had to take special care of their teeth, eyes, and extremities, but he continued his careless ways. To avoid teasing by his teammates, Josh quit wearing his water shoes at swim prac tice and between events. The abrasive cement of the pool deck daily scraped his soles. His heel became tender, swollen, and red, but Josh ignored this warning. By mid-July, as swim season concluded, Josh started limping slightly and told his inquiring parents it was just a pulled muscle. But as football started in August, Josh couldn't ease his infected foot into a cleat and was forced to admit his problem and accept help. Under local anesthesia, Dr. Larkin lanced Josh's left heel and a foul-smelling, cottage cheese-like substance burst out. A sample of the purulent mass was collected for the lab before Dr. Larkin began debriding the foot. Josh knew he was in trouble. Dr. Larkin didn't say a word. He just kept working. Numerous other samples were collected for the microbiology laboratory. Josh was given IV clindamycin during the procedure and prescribed Cefoxitin and ciprofloxacin to con- tinue at home. Direct examination of the specimens consistently revealed Gram-positive cocci in clusters, Gram-negative rods, and, in the deeper tissue samples, small Gram-negative coccobacilli were abundant. 1. What types of media were used to inoculate Josh's specimens? 2. Why were three different microbial species observed? Did the sician use poor technique during specimen collection? Why do you think the one species was evident only in igure 1. Gram stain of mixed bacterial nfection tissue samples? deeper

Answer 1

1,Selective and Differential media were used to inoculate josh's specimen's..It generally used to identify the particular organism..Selective media inhibit the growth of other organism and allow some type of organism to grow..Differential media used to differentiate closely related organism or group of organism..For the correct diagnostic purpose selective and differential media used to differentiate the growth pattern of organism..
2, Here we observed three different microbial species like gram-positive cocci, gram- negative rods and small gram-negative coccibacilli..Differentiating between these groups of cocci easy but differentiating between these species within a genus is complex..For proper diagnostic purpose physician used this technique during specimen collection..gram -positive cocci belonging to the general staphylococcus and streptococcus and gram -negative cocci..both pathogenic and nonpathogenic species occur in the gram-negative cocci..
3, Staphylococcus epidermidis:
It is gram positive,coagulase -negative cocci part of normal flora..It is pathogen of nosocomial infection due to foreign body infection..this organism produce glycocalyx 'slime' acts as a glue attach with plastic and cells and cause resistance to phagocytosis and some antibiotics..Route of infection through Intravascular devices,catheters and large wounds..
Pseudomonas aeruginosa:
It is a important cause of gram-negative infection and cause nosocomial infections..Route of infection through hands of health care professionals or by equipments ,devices like catheter, patient with wound from surgery or burns..this infection may occur after exposure to inadequately chlorinated hot tubs or swimming pools..
Bacteroides fragilis:
It is a important anaerobic pathogens in human infections..pathogens associated with polymicrobial infections like diabetic foot,skin infection etc..This virulence of pathogens may spread the infection and abcess formation..
4, Osteomylitis is an infection of the bone..this infection caused by staphylococcus aures and type of staph bacteria..In case of diabetes it will increase the risk for osteomylitis..this organism travel through the blood stream and cause bone infection..This infection spread to another area through blood stream..In chronic infection of the bone it take longer time to heal..Treatment should be effective because an amputation may required sometimes..