Question

What is the significance of him being at group daycare? What special characteristics allow this organism to spread?

Was it surprising that this patient had a negative blood culture? Explain and defend.

20-Gastrointestinal Infections The patient is a 4-year-old male who presented to the emergency room with a 2 hour history of vomiting, diarthea, fever, irnitablity, and lethargy. The child had gone to sleep on the living room couch at 23:00. His grandmother found him on the floor at 03:00 covered with feces. When she picked him up to carry him to the bath tub, she noticed he was febrile (showing signs of fever) She bathed him, and brought him to the emergency room. The patient's medical history was significant for his being in group day care. in the emergency room, he had two episodes of vomiting. His temperature was 38.9 with a pulse of 160 BPM. He was also noticeably dehydrated. His stool contained bloody streaks, and a methylene blue stain of his feces is shown in Figure 1. Other laboratory studies included CSF examination (dtue to his lethargy), which was normal. A peripheral WBC count was perfonned yeldung 13,200 cellsuk with 85% neutrophils. His blood culture was negative for organism His stool sample was negative for parasitic ova Figure 2 shows a MAC plate with the growth of the recovered organism. The organism was found to be non-motile, urease negative, indole negative, and a TSI slant showed no fermentation of sucrose or lactose, with no hydrogen sulfide production. Figure 2: Organism grown on MAC after 18 hour incubation. Figure 1: Methylene blue stain of the child's feces

Answer 1

#. The child was severly dehyrated that he needed IV fluid administration, antibiotics, transfusions if needed , CSF has to be done as he was lethargic and irritable and tachycardia was present,for all these supportive care the child has to be admitted immediately that's why he was admitted in the daycare.

#. The special characteristic for this organism to spread is ability to reproduce and to mutate

#. No, there was nothing to be surprised with the negative blood culture because the causative agent is a virus .