Casos Bacteriología Cocos Gram Positivos & Cocos Gram Negativo (Spts.)An 18-year
ID: 187145 • Letter: C
Question
Casos Bacteriología Cocos Gram Positivos & Cocos Gram Negativo (Spts.)An 18-year-old man fell on his knee while playing basketball. The knee was painful, but the overlying skin was unbroken. The next day, the knee was swollen and remained painful the next day, so he was taken to the local emergency department. Clear fluid was aspirated from the knee, and the physician prescribed symptomatic treatment. Two days later, the swelling returned, the pain increased, and erythema developed over the knee Because the patient also felt systemically ill and had an oral temperature of 38.8°C, he returned to the emergency department. Aspiration of the knee yielded cloudy fluid, and cultures of the fluid and blood were positive for Staphylococcus aureus. Name two possible sources of this organism. Staphylococci cause a variety of diseases, including cutaneous infections, endocarditis, food poisoning, SSSS, and TSS. How do the clinical symptoms of these diseases differ from the infection in this patient? Which of these diseases are related with toxins? 1. 1. 2. 3. What is the antibiotic of choice for treating staphylococcal infections?Explanation / Answer
1. Possible source
Skin, hair, most possible breaking skin
2. Symptoms of various disease
They are only able to invade via broken skin or mucous membranes, hence intact skin is an excellent human defence. Once they have invaded they have various ways to avoid host defences.
a. Cutaneous infection
Staphylococci are a common type of bacteria that live on the skin and mucous membranes. S aureus infection is common in people with frequent skin injury, particularly if the skin is dry. Impetigo, Ecthyma ,Cellulitis, Secondary skin infection of wounds, dermatitis, scabies, diabetic ulcers etc.
b. Endocarditis
Infective endocarditis (IE) is defined as an infection of the endocardial surface of the heart. Its intracardiac effects include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. Symptoms lead to Fever, possibly low-grade, intermittent, heart murmurs and Petechiae, Splenomegaly, Stiff neck, Delirium, Paralysis, hemiparesis, aphasia, Conjunctival haemorrhage etc.
c. Food poisoning
Contaminated food, such as handling of food, equipment, surfaces, properly refrigerated can cause the food poisoning. These bacteria multiply quickly at room temperature to produce a toxin that causes illness. Symptoms are Nausea, vomiting, diarrhea, loss of appetite, severe abdominal cramps, and mild fever.
d. SSSS
Staphylococcal Scalded Skin Syndrome (SSSS) also known as Ritter von Ritterschein disease. Ritter disease, and staphylococcal epidermal necrolysis, encompasses a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of some strains of Staphylococcus aureus. It is a syndrome of acute exfoliation of the skin typically following an erythematous cellulitis.
e. TSS
Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyelitis, necrotising fasciitis, or pneumonia.
f. Toxins related disease
Some strains produce one or more additional exoproteins, which include toxic shock syndrome toxin-1. Alpha-hemolysin (Hla), is the major cytotoxic agent released by bacterium Staphylococcus aureus. Above Food poisoning and TSS Disease most related to the S aureus toxin.
3. Antibiotic
The combination of Cephalosporins, Penicillins or Vancomycin. Other than Clindamycin or Gentamicin may be used to reduce toxin production and mortality.
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