Question

A 20-year-old college junior comes to the student health office because she has been exposed to rubella during a recent outbreak at the college. She has been immunized as a child.

Laboratory Data:

Hemagglutination inhibition test for Rubella: negative

Pregnancy test: positive

Ultrasonography shows the fetus is in the eighth week of development.

Questions:

1. Is this woman susceptible to rubella infection?

2. Is the fetus at risk of a congenital defect?

3. Is there any treatment for the infection?

4. What are the immunologic manifestations of infections?

Case 7

History and Physical Examination

A 24-year-old female with a history of AIDS presents for evaluation of left-sided weakness. She has also been experiencing headaches and seizures, and others have observed an alteration in her mental status. Her medical history is notable for an episode of Pneumocystis carinii pneumonia, primary syphilis treated with penicillin 5 years ago, and occasional thrush. She takes zidovudine and monthly aerosolized pentamidine for pneumocystis prophylaxis. An urgent CT scan of the head shows two 1-cm lesions in the right basal ganglia with enhancement seen with intravenous contrast media.

Laboratory Data:

CD4 cell count: 50 x 109/L

RPR: positive at 1:2

Toxoplasmosis IgG: positive

Toxoplasmosis IgM: negative

Questions:

1. What is the most common cause of lesions in the brain?

2. What is the source of this infection?

3. Is this a newly acquired infection?

4. How can the patient be treated?

5. Should pregnant women be tested for this microorganism?

Answer 1

1.1)she has taken rubella vaccination thus she does not effect with rubella virus

2)definitely foetus can get congenital abnormalities as rubella vaccination is contra indicated during pregnancy.

3)rubella vaccines can be used as preventive medicine.some analgesics also can be given.

4)headache,muscle pain,red rashes on face then spread to other part of body,fever,running nose,enlarge lymph nodes.

2.1)it can be CMV(cytomegalo virus) enchaphalittisi

2)HiV virus is the mostcommon cause of lesions in the brain in an AIDS patient.

3)it can be a newly acquired infection due to the less immunity in an HIV infected patient

4)anti viral medication can be used to treat cmv infected patient.

5)aminocentesis can be done in pregnant women to know the baby is infected or not