Question

BIOL 2267 Ch. 19-Respiratory Infections The patient was a 55-year-old male with a 2-month history of fevers, night sweats, increased cough with sputum production, and a 25 pound weight loss. The patient denied IV drug use. The patient claims to have had multiple heterosexual sexual encounters over the past several months, and "sips" a pint of gin daily. He was jailed two years ago in Chicago and has a history of multiple gunshot and stab wounds. His physical examination was significant for bilateral anterior cervical and axillary adenopathy and bilateral interstitial infiltrates. His laboratory findings were significant for HIV+ serology and a low absolute CD4 lymphocyte count The result of a Gram stain was inconclusive. The laboratory technician performed arn acid-fast stain of the sputum as shown in Figure 1. Figure 2 shows the organism causing his infection after 6-weeks of incubation. The same organism was detected in bronchoalveolar lavage fluid from the right middle lobe. Figure 1: Acid-Fast stain of Figure 2: Six-week old colonies unknown organism grown on Lowenstein-Jensen agar

Answer 1

1. Bronchoalveolar lavage is a medical procedure. It was performed as bronchoscope is passed through the mouth or nose into the lungs.and collect the fliud from the part of the lungs.main purpose was to diagnose the lungs diseases.

2.genus mycobacterium and genus nocardia along with few bacteria are positive for acid fast stain.

It was characterised by was like impermeable cell walls , presence of bucolic acid , large amount of fatty acids , and complex lipids.

3.patient affected by mycobacterium tuberculosis and patient had an multiple heterosexual encounters due that he had HIV positive with evidence of less count of CD4 and weight loss.

4. Factors are denied if drug use

Multiple heterosexual encounters

History of 2 month fever, cough with sputum Production and weight loss and night sweats...

5.PPD TEST is purified protien derivatives.also called as mantoux test. It was performed for screening the tuberculosis.In patient value is ppd test is positive. Along with PPD test we should order the additional tests like chest x ray for confirmation and sputum culture , and TB resistance test.

6.infection control measures are isolated patient with active tb from other patients.

Provide continue airborne isolation with active tb patient

Provide adequate ventilation in health care settings

Conduct periodic air exchange measures and airflow evaluation.

Provide proper cleaning and disinfectant measures to patients.etc..

Periodic assessment for detect risk factors.