Question

The patient was a 23 y/o female with an autoimmune connective tissue disorder who presented with fever, left foot, and right upper quadrant pain, nausea, and vomiting. An exploratory la perfor peritoneum. revealed cocci. Gram staining an aspirate of the fourth metatarsal joi organisms were seen. A blood culture collected on admission, joint, and peritoneal aspirates grew the same organism. On a sheep blood agar plate the organism produced large, transparent to translucent co parotomy was med during which 300 ml of greenish, nonodorous purulent material was aspirated from the An appendectomy was performed as well. A gram stain of the aspirate of the peritoneum the presence of moderate polymorphonuclear leukocytes (PMNs) and a few gram positive nt revealed numerous PMNs, but no lonies with large zones of beta hemolysis. The gram positive cocci were catalase negative. When colonies are mucoid, this usually indicates the presence of which virulence factor? Based on the sites of the infection, which three types of infections does this patient have? On the basis of the Gram stain and the infections observed, this organism belongs to which genus? What further characteristics of this organism would be helpful in determining its identity? What organism is this? What life-threatening, non-suppurative sequelae can follow infection with this organism? 1. 2. 3. 4. 5. 6.

Answer 1

1. ANSWER : When colonies are mucoid, it indicates the presence of Klebsiella Pneumoniae virulance factor.

2. ANSWER : The three types of infections the patient is having is - 1. presence of greenish, non odorous purulent material in the peritoneum, 2. presence of poly mophonuclear leukocytes in peritoneum and gram positive cocci, 3. presence of transparent colonies with large zones of beta hemolysis on sheep agar plate.