Question

need help with questions 1-3

1. A 44-year-old man presented with a 3-month history of intermittent fever, chills, and a cough with production of yellowish-green sputum. He also complained about weakness, weight loss, chest pain, and shortness of breath. He had been given several courses of antibiotics without significant improvement and had noted the presence of a headache for the past few weeks. He had a history of COPD and had been on anti-inflammatory steroids for the past 6 months. A chest x-ray revealed extensive infiltrates in the right middle and upper lobes. What is the most likely cause of this disease? How would you confirm? How would you treat? 2. A 3 week old baby boy was brought to the ER with a 24 hour history of fever, poor feeding, irritability, and a seizure that occurred just before arriving at the ER. He was bom preterm (32 weeks) with very low birth weight after a normal vaginal delivery. What is the likely causative agent? How would you treat? How could have this infection been prevented? 3. Fluid accumulation in the lungs is called

Answer 1

1. Malaria. Parasites (Sporozites of Plasmodium) reproduce asexually in RBC's , thus bursting the RBC's and causing intermittent fever. Yellow - green sputum is produced in the case of severe infection. Because of loss of blood RBC's the person feel weakness and weight loss.  Antibiotics can't affect the sexual reproduction of sporozites. May be that's why administration of many antibiotics dont reduce malaria. Another is due to increased resistance to antibiotics by the bacteria. As the patient was a COPD patient earlier he/she must have administerd many antibiotics before hence developed resistance.

Cause - due to presence of plasmodium , a infectious protozoan. It enters our body as sporozites through the bite of Anopheles mosquito. they intially multiply in liver cells and then attack RBC's , resulting in their rupture. The rupture of RBC is associated with intermittent fever due to release of a toxic substance called haemozoin .

We can confirm malaria by examining a drop of blood under microscope and look for sporozites - infectious forms.

Treatment include taking drugs like malarone, mefloquine, qualaquin with doxycyclin.