A female patient has been suffering from continuous diarrhea for a week. The sto

Question

A female patient has been suffering from continuous diarrhea for a week. The stool had a metal like smell. The patient is a nurse at an Assisted living home. She felt sick a week ago and her symptoms resembled that of one of her own patients. Her symptoms have been worsening to the point she is very sick and had to take time off. 1. What disease does she have? Name the causative agent. 2. How did she become infected with this microbe? Explain the pathogenesis of this disease. 3. What is the virulence factor and how would you treat this disease? 4. What would you advise the patient to do in the future to avoid such illness in particular in her line of work.

Explanation / Answer

1) she is having Giardiasis commonly known as beaver fever which is caused by giardia lambia . It is a parasitic infection .

2) patient is a nurse who is working in a assisted living home . So her duties mainly including assisting of patient while doing their self care also. Giardiasis mainly spread through feaces contaminated food or water which is then eaten or drink . Risk factors like changing diapers and improper hand hygiene . She may got this by her improper hand hygiene after patient

PATHOGENESIS

Giardia has one of the simplest life cycles of all human parasites. The life cycle is composed of 2 stages: (1) the trophozoite (see the first image below), which exists freely in the human small intestine; and (2) the cyst, which is passed into the environment. No intermediate hosts are required.

Upon ingestion of the cyst (see the second image below), contained in contaminated water or food, excystation occurs in the stomach and the duodenum in the presence of acid and pancreatic enzymes. The trophozoites pass into the small bowel where they multiply rapidly, with a doubling time of 9-12 hours. As trophozoites pass into the large bowel, encystation occurs in the presence of neutral pH and secondary bile salts. Cysts# are passed into the environment, and the cycle is repeated .

3)

Common symptoms include:

Treatment :

In most cases Giardiasis doesn't require any treatment . It will subside but it's own by maintaining preventive measures

Medications are used effectively to treat giardiasis.

Metronidazole (Flagyl)

Quinacrine

Nitazoxanide (Alinia)

Other treatments

4) she is a nurse who is working in a assisted living home . She is always busy with patients . So she needs to maintain proper hand hygiene . Before and after touching patient . Before and after doing all procedures . After coming contact with patient body fluid . Its a feco oral route transmission disease . So hand hygiene must be maintained .

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