Question

ART II. Case studies (10 points) -Name the genus and species of each of these. 1. A 15-year-old high school student who had no prior known renal disease developed a sore throat and 103 Ffever. The fever and sore throat lasted for three days. Ten days later, he developed hematuria, puffy eyelids, and swollen ankles. He went to a physician, who noted an inflamed pharynx, enlarged and reddened tonsils, and palpable cervical lymph nodes. The patient had pitting edema of his feet and pretibial areas and a blood pressure of 165/105 mm Hg: the urine contained 4+ protein, 20 to 30 erythrocytes and 20 to 30 leukocytes per high field, some hyaline and granular casts, and one erythrocyte cast. The patient was admitted to the hospital where laboratory investigations included throat culture, serum for antistreptolysin O titer and beta 1C globulin (C3 component of complement system), and renal function evaluation. The patient was given bed rest and 1,200,000 units of procaine penicillin intramuscularly. The throat culture was positive, the antistreptolysin Otiter was 166 units per ml, C3 was 53 mg per 100 ml (normal, 110 to 160 mg per 100 ml), and the serum creatinine was 2.5 mg per 100 ml (normal, less than 1.5 mg per 100 ml). he microbe is: 2. A 25-year-old female was hospitalized because of increasing shortness of breath and development of a cough with blood-tinged sputum. Except for asthmatic attacks precipitated by various environmental allergies, she had always been in good health. One week before hospitalization, this patient had developed what she called "a cold" characterized by a mild sore throat and nonproductive cough. malaise, and a generalized dull headache. Three days prior to hospitalization the patient experienced a 15 minute severe shaking chill. After this episode the cough became worse and more productive of sputum (bloody looking). A physical examination revealed an oral temperature of 104 F, pulse 124 per minute, and blood pressure 112/70. Respirations were 36 per minute; each expiration was accompanied by a "grunt". The chest was hyper-resonant to percussion and filled with inspiratory and expiratory wheezes. Fine crackling rales were heard on inspiration over the lower anterior chest just to the right of the sternum. The patient had a total leukocyte count of 12,500 per cubic millimeter, with 7196 segmented neutrophils, 17% band cells, 1196 lymphocytes and 1% eosinophils. Urine was found to have a pH of 5.5 and gave a 1 + reaction for protein. A freshly collected sputum was gram stained and revealed numerous gram positive cocci and rods. Chest xray revealed a distinct infiltrate involving the right middle lobe. The Quellung reaction was positive. The patient's physician ordered procaine penicillin, 600,000 units via the intramuscular route every 6 hours and intermittent positive pressure breathing treatments to relieve the bronchospasm and allow the patient to rest more comfortably. le microbe is:

Answer 1

1).GAS ( Group A Streptococcus) :- Pharyngitis strain 1,12..

Species - S. pyogenes

2). Streptococcus pneumonia.... Because Quellung reaction is positive...

3). Lyme disease due to Borrelia burgdorferi..

4). Clostridium botulinum.. Types of antitoxin given suggest the disease..

5). Neisseria meningitides ( meningococcus) :- neck stiffness suggest meningitis and gram staining reveals gram negative diplococci..

6). Group A beta hemolytic streptococcus..

7). Brucella melitensis :- Brucellosis..

Classic lriad: lliough die manifestations vary, die classic triad of fever with profuse night sweats, arthralgia/ arthritis and hepatosplenomegaly .

Undulating fever: Fever has a typical reminent course,
i.e. in between febrile period~ (which last for weeks),
there will be afebrile periods. ll is also called Malta
fever or Mediterranean fever.
• Musculoskelelal symptoms are present in about
one-half of all patients, which may mimic skeletal
tuberculosi~.
Vertebral osteomyelitis involves lumbar and low
dioracic vertebrae commonly.
• Septic ardiritis: Most commonly affected joints are
knee, hip, sacroiliac and shoulder joints.
• Other nonspecific symptoms: lliese include
abdominal pain. headache, diarrhea, rash, weakness/
fatigue, weight loss, vomiting, cough, pharyngitis.

8). Non tuberculous mycobacteria:- nonprodctive cough no sputum,

9). Neisseria meningitides.. Flattened adjacent sides gram negative diplococci. And biochemical result..

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