Question

Case study 2

Adam and his wife Brenda are organic farmers. They live in northern California and believe in a natural life style, free of pesticides, processed foods and they do not believe in vaccinations or un-natural medications. They have 4 healthy happy children. But lately their younger son Billy, who is 7 years old has not been feeling well. About a month ago he had a sore throat and slight fever, which subsided in a day or two. He had a mild episode of diarrhea about a week ago and would not eat and was listless. They tried their home remedies and he got better. But Brenda noticed that Billy was having trouble walking the previous night, he seemed weak and listless again, and he seemed to have had troubles dressing himself and walking that day.

They tell the doctor that they lived in NYC but became “totally organic 8 years ago” and moved to California. They report that their older children, now 20, 19, and 18 years old, were given all required vaccines, but Billy had never been vaccinated against any disease.

On examination, the patient had no significant fever (98.9) and normal bowel sounds. His chest, ears and eyes were clear. He had no rebound tenderness in the abdomen. The doctor noted that Billy had poor muscular reflexes in his arms and legs, he was also lethargic and seemed confused.

Urine, stool and blood samples were collected for analysis.

1-What is the most likely diagnose for this disease? (40 points)

2-What causes this disease? (40 points) DO NOT GIVE ME A LIST OF POSSIBLE INFECTIOUS AGENTS, IF YOU DO SO YOU GET 0 POINTS, THAT IS NOT SOLVING THE CASE, THERE IS ONLY INFECTIOUS AGENT THAT CAUSES THIS CONDITION.

3-What tests can be used to confirm of your diagnosis? (15 points)

4-Would receiving childhood vaccines series have prevented this problem? (5 points)

Answer 1

1.After considering the signs and symptoms,the diagnosis is Poliomyelitis.Many people with polio do not exhibit many symptoms,but there may be symptoms like fatigue,feeling faint,fever,muscle weakness,headache,nausea,slow growth.Also the patient didn't take any immunizations in hif life.

2.The disease is mainly spread through contaminated food and water.There are 3 types of poliovirus type1,type2 and type.Poliomyelitis can spread from person to person.

3.The diagnostic measures of polio includes culture,PCR,genome sequencing and serology.I can often recognize by symptoms such as neck and back stiffness,abnormal reflexes,and difficulty in swallowing and breathing.Sample of throat secretions,cerebrospinal fluid is also checked for poliovirus.

4.Polio can be prevented only by immunization.The oral polio vaccine,that is attenuated and inactivated polio vaccine contains killed viruses.