A 27-year old white female presented her self at her local physician on August 1

Question

A 27-year old white female presented her self at her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender abdomen and complained of headache, stiff neck and backache with diarrhea. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the University in her town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of flies in the area. She felt sick the last day there after eating some canned food, as there was no cooler there. You had no time for culturing, as you need to take action fast.

1. What type of disease she could have based on the symptoms and why? You are not required to name a disease naming a disease means you have answered the question wrong.

2. What features are not critical to your diagnosis from the case & why?

3. What further steps should be taken to precisely identify the case & why? What microbes you will not consider and why [name 4

4. What steps would you take to ensure that the patient is stable till diagnosis is confirmed; explain why would you do this?

Explanation / Answer

1. Stiff neck, fatigue, tender abdomen, headache, and diarrhea, and lack of concentration are the symptoms given. she felt sick after eating canned food.The patient was in wild for some time. The symptoms and her history presents she sufferred from food poisoning and the causative agent might be anaerobic bacteria.

2. The presence of large number of fleas is not critical. Vector borne diseases require insect bite, and transmission of pathogen through the vector. The disease onset generally takes some time, that it, incubation time is required before onset of symptoms.

3. Body fluids like blood, cerebrospinal fluid, and feces shall be cultured to detect the causative pathogen. Clostridium and Bacillus are not considered because they do not cause stiff neck and inability to concentrate. These two are generally the symptoms of CNS infection.

4. Pain killers given to relieve the patient of pain. Oral rehydration therapy or intravenous fluid injection to be given since the patient is sufferring from diarrhea. Antibiotic therapy should be given to ensure further replication of the pathogen does not occur.

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