Read the overview and complete the interactivities that follovw. In 2008, 65-yea
ID: 148018 • Letter: R
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Read the overview and complete the interactivities that follovw. In 2008, 65-year-old Mr. Jones woke up complaining of abnormal fatigue and a scratchy throat. His wife took his temperature and found it to be slightly elevated. He dismissed the condition, blaming it on long days in the garden and an allergy attack. However, his symptom list grew over the next few days. He lost his appetite, his joints and muscles were sore, and he woke up wringing wet from night sweats. He continued to have a fever and his wife was worried at how pale he looked. She insisted on a doctor's visit, and after a physical and throat culture, he was sent home with instructions to take oral penicillin and Tylenol Symptoms continued for a week, with additional complaints of headache, rapid breathing, and coughing. Heart rate was rapic, and Mr. Jones had a slight heart murmur but his throat culture was negative. As the physician begin to look for other causes, he learned from Mr. Jones that an artificial heart valve had been implanted in his heart 10 years earlier. He also learned that Mr. Jones had been treated for a skin infection with MRSA, a drug- resistant strain of Staphylococcus aureus several months prior to the onset of these symptoms. These details caused immediatee alarm, and Mr. Jones was rushed to the intensive care unit and placed on a mixture of IV antibiotics. By evening, he became confused and lost consciousness, and despite efforts in the operating room, Mr. Jones died during open heart surgery. Blood cultures taken before Mr. Jones died grew MRSA, and during arn autopsy, the pathologist also noted small patches of S. aureus growing on the prosthetic valve. He concluded that Mr. Jones had infective endocarditis and had died when portions of the biofilm on the valve broke loose into his circulation.Explanation / Answer
1) Penicillin is ineffective against methicillin resistant Staphylococcus aureus. Methicillin is an antibiotic belonging to penicllin class. The infectious agents was resistant to the prescribed drug penicillin.
2) Artificial valves allow the attachment and growth of bacteria more than normal valves. They support biofilm formation by pathogenic microbes. People with artificial valve implant are at a risk of developing endocarditis.
3) Mr Jones was potentially sufferring from endocarditis caused by MRSA. It is evident from the fact the same bacteria was isolated from his implants and blood stream. Therefore he needed to be treated with more powerful antibiotic for treatment of this drug-resistant infection. The skin infection must have spread via bloostream to heart valves causing endocarditis.
4) Microbial biofilms cause 80% of chronic infections.
5) All are symptoms of endocarditis
6) Mr. Jones died of stroke due to blockage caused by loosened piece of biofilm. In chronic endocarditis which is an inflammation of endocardium lining heart chamber and valves, bacteria infect the valves. Various immune cells, platelets and clotting factors migrate to this region and inflame it causing clumping of cells. In Mr jones case, the immune cell inflamed biofilm breaks off and goes into bloodstream where it clogs the blood vessels causing stroke.
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