Question

28. A 55 year old male was exposed to aerosol from an air conditioner, ate a casserole containing meat that was held at 110 degrees F for 4 hours, suffered from gum disease and is diabetic.Two weeks earlier he returned from a trip to Pakistan. The patient was admitted to the intensive care unit. His physical check revealed the following: mitral valve regurgitation, Fever 103 F, family reported that he had nausea and vomiting earlier in the day, blood pressure was abnormally low and falling, blood gases revealed poor oxygenation. Patient was drowsy and had difficulty in communicating with hospital staff. Auscultation of lungs revealed presence of fluid.  

          1) What are some of the specific pathogens that may be involved in this patient ( why?)

2) What appropriate and specific microbiology lab tests are needed?

3) What complications may be starting with the patient (why and briefly how)?

Answer 1

1 . This patient may be exposed to pathogens like Streptococcus pyogens, Group A streptococcus, air borne pathogens from air conditioner like Aspergillus fumigatus , Mycobacterium or the different virus that causes flu.

2 . Blood culture , throat swab culture and sensitivity are the microbiological tests conducted to reveal the pathogen.

3 . There may be severe food poisoning in this case due to exposure to contaminated meat and also strept throat which has affected heart. Heart and lungs too are involved. Pneumonia too is present along with decreased oxygen saturation. The person has a respite distress as a complication which may require intubation and mechanical ventilator for oxygen support.

Thank you.