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ID: 191334 • Letter: P
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BIO 205 Assignment-Pediatric Case Study A patient has been admitted to your pediatric intensive care unit. He is a twelve-week- old male who was transferred to your institution with a five-day history of frequent coughing. During these bouts of coughing the patient would frequently turn blue and expel massive quantities of mucus. Occasionally the coughing would be followed by vomiting. Shortly before admission the parents noticed the infant's coughing had become so severe that he lost consciousness several times. On admission the patient's pulse and respiratory rate were both highly above normal, but his chest radiograph showed no foreign masses and there was no evidence of an airway obstruction. His leukocyte count was 16,000/ul with 70% lymphocytes. Cerebrospinal fluid measurements were within a normal range. When the patient's throat was swabbed, no microbes could be grown on normal agar. His diet consisted primarily of breast milk, and occasionally honey. The patient's medical history revealed that he had received no immunizations The father had recently returned from Western Uganda where he had been performing anthropological research on local populations in the area. Both parents had visited various parts of Africa over the previous decade.Explanation / Answer
identification: bacterium Corynebacterium diphtheriae
reasoning: As given:
1. The child is not given any immunisation.
2. his parents have been to a country where the immunisations are not properly provided
3. skin turns blue
4. Heart beat increases
5. vomitting
6. coughing followed by a lot of mucus expelsion
7. breathing heavily(respiratory problems)
8. the bacteria couldn't be grown on normal agar(only in blood agar,Loeffler's medium and trypticase soy agar)
Domain and kingdom: Bacteria
Transmission,Entry,mechanism of action and body system:
1.Diphtheria is spread (transmitted) from person to person, usually through respiratory droplets, like from coughing or sneezing. Rarely, people can get sick from touching open sores (skin lesions) or clothes that touched open sores of someone sick with diphtheria. A person also can get diphtheria by coming in contact with an object, like a toy, that has the bacteria that cause diphtheria on it.
2.Diphtheria bacteria can enter the body through the nose and mouth. It can also enter through a break in the skin. It is spread by breathing in droplets that contain diphtheria bacteria from an infected person when he or she coughs, sneezes, or laugh.
3.Once infected, the bacteria quickly multiply within the body and spread through the inner lining of the throat, mouth and nose. The bacteria produce a toxin that kills cells in the throat. These cells then join to form the grey–white membrane that is typically seen in cases of diphtheria. The toxin can also spread via the bloodstream and cause damage to the nervous system and heart.
Not all diphtheria bacteria produce the diphtheria toxin. Only those that are infected with a bacteriophage can produce the toxin. The bacteriophage transfers the genetic material that codes for the toxin into the bacterial DNA.
The diphtheria toxin is a single polypeptide made up of fragment A and fragment B which are connected by a disulfide bond. Fragment B binds to the EGF-like domain of the heparin-binding EGF-like growth factor (HB-EGF) present on the surface of cells. This causes the cell to engulf the toxin inside an endosome, where it is divided into its two fragments.
The acidic environment of the endosome triggers fragment B to make holes in the membrane of the endosome. This allows fragment A to be released, which moves into the cell’s cytoplasm where it prevents the formation of new proteins by interrupting an essential step in protein synthesis.
4.When the bacteria that causes Diphtheria gets inside the body and attaches itself to the lining of the respiratory system, it produces a toxin that causes a lot of discomfort to the infected person. These troubles act like symptoms of Diphtheria.Common symptoms are:
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