In early spring, a 45-year-old farmer from New Mexico arrived at the Emergency Room, struggling to breathe. He reported no history of chronic pulmonary disease and the ER ruled out malignant causes of his condition. His blood tests showed neutrophilic leukocytosis and thrombocytopenia. He reported feeling extremely fatigued the last few days, coupled with muscle aches and a fever. In particular his thighs, hips, and back had been aching. In addition, he was experiencing headaches, dizziness, and vomiting. He had not traveled anywhere recently and reported no changes to his diet. The only abnormal activity he reported in the last six weeks was cleaning out his old barn to get ready for the spring.
1. What did this patient have? 2. Describe the microbe that causes this infection (cellular structure and features, it’s reservoir, etc.) 3. How do you think he became infected, and is he contagious to others?
Ans 1: Since the patient's blood test was reported of having positive result for neutrophilic leukocytosis and thrombocytopenia and the patient had cleaned the old barn. Therefore a conclusion that the patient is suffering from influenza (flu) can be derived. Influenza is a disease commonly associated with these two conditions and is also reported to transmit from animals to humans.
Neutrophilic leukocytosis is a condition where abnormally a high number of neutrophils are present in blood. It is a type of white blood cells that fights against pathogens invading the body and helps the body to heal injuries. Thrombocytopenia on the other hand is nothing but a condition in which the level of platelets drops and the ability of the blood to clot is compromised. Since platelets helps the blood to clot incase of bleeding hence low level of platelets counts is dangerous.
Ans 2: Influenza or flu belongs to the family of viruses usually known as Orthomyxoviridae. It has been studied to possess all the important genetic information in the form of RNA. Influenza is of three types: A, B and C. And humans can be infected by all, but type A virus are the most common causes of widespread illnes and epidemics. Type A influenza is commonly carried by animals such as birds.
Structure: The virus is spherical in shape and is enveloped with outer layers made from lipid membrane with spikes of glycoproteins known as hemagglutinin (80%) and neuraminidase (20%). Beneath the lipid membrane is the matrix protein which makes the shell and gives strength and rigidity to the envelope. The influenza contains 8 RNA segment that is tightly encapsulated and that which gets released into host cells after invasion. This RNAs are coiled in the ribonuclear proteins or RNPs. This 8 RNA segment is the genetic material of the virus and they code for one or two proteins.
Features: Influenza Type A
Membrane proteins- Hemagglutinin, Neuraminidase and Matrix Protein I.
Epidemiology- Pandemic.
RNA segment- 8.
Host- Humans, birds, pigs, horses and seals.
Influenza Type B
Membrane proteins- Hemagglutinin, Neuraminidase and Matrix Proteins.
Epidemiology- Epidemic.
RNA segment- 8.
Host- Humans and seals.
Influenza Type C
Membrane proteins- Hemagglutinin Estrase, Fusion Proteins and Matrix Protein 2.
Epidemiology- Epidemic.
RNA segment- 7.
Host- Humans and Pigs.
Reservoir: Studies shows that humans are the principal reservoir of Influenza virus with type A predominantly found in ducks, geese and shorebirds etc. And animals like pigs and horses too.
Ans 3: Infiuenza is commonly caused by the following:
-Airborne respiratory droplets like coughing or sneezing.
-Direct Contact like skin-skin through handshakes or hugs and touch.
-Saliva contact like kissing or shared drinks.
-Touching contaminated surface like cloths, utensils, blankets, crafts, doorsknobs and tables etc.
Since this disease is mostly transmitted through direct or contaminated environment hence the patient got infected by the virus as the working environment of barn includes direct contact with animals.
In early spring, a 45-year-old farmer from New Mexico arrived at the Emergency Room, struggling to...
David, a 43-year-old man, arrived at the emergency room with hematuria and pain. He reported a history of kidney stones going back to when he was sixteen. His doctor at that time had told him it was a metabolic disorder. A routine urinalysis and kidney stone analysis were ordered. Color Amber Clarity Clear Bilirubin Negative Nitrite Negative Blood 4+ pH 7.0 Glucose Negative Total Protein 2+ Ketones Negative Specific Gravity 1.010 Leukocytes 1+ Urobilinogen 2 mg/dL Microscopic >100 RBC/HPF >100...
Albert, a seventy-two year old African-American man, is brought into the emergency room by his daughter. Approximately 45 minutes before arriving, Albert dropped his book when his right arm and hand "fell asleep". When he tried to rise, he noticed his right leg was weak and he needed to hold onto the couch to stand up. He had a difficult time talking because the right side of his face and mouth were "numb" and his tongue felt "thick". In obtaining...