Tuberculosis: \"I\'ll Be Back\" Michael, 45 years old, is a cook at a fast-food

Question

Tuberculosis: "I'll Be Back"

Michael, 45 years old, is a cook at a fast-food restaurant in Rome, Georgia. He went to see his physician because he was feeling fatigued, was unable to sleep, had lost his appetite, and had been coughing for several weeks. His sputum (material coughed from deep in the lung) contained acid-fast bacilli, and a chest X-ray revealed scattered, small (1–5 mm) granulomas (nodules of inflammation) throughout both lobes of the lung. The physician diagnosed Michael with secondary tuberculosis. Secondary tuberculosis is caused by bacteria reactivated from old lesions in which bacteria have persisted in a dormant state. The causative bacterium is Mycobacterium tuberculosis, a facultative intracellular pathogen that infects only humans and is transmitted through respiratory droplets. Michael was placed in isolation and started on a long-term, four-drug treatment regimen consisting of isoniazid (fatty acid synthesis inhibitor), rifampin (transcription inhibitor), pyrazinamide (fatty acid synthesis inhibitor), and streptomycin (protein synthesis inhibitor). The four-drug therapy continued for 2 months, followed by 4 months with isoniazid and rifampin only. Michael responded well to treatment. Luckily, he was not infected with one of the highly dangerous multidrug-resistant strains (MDR-TB).

Part 1

The organism that caused Michael's infection -------- an outer membrane

A) has B) doesn't have

Part 2

Part 3

If the mucous that Michael coughed up was streaked on a plate, colonies were isolated, and the bacteria were used for an acid-fast stain, the Mycobacterium tuberculosis cells would most likely appear dark/deep A) Blue B) pink C) green D) purple

2) Not all spirochetes are pathogenic to their hosts. This statement is  A) true B) false.?

Explanation / Answer

Part 1

Option A.

Because of the presence of the thick outer membrane (Mycolic acid - fatty acid) in Mycobacterium tuberculosis, they are resistant to host immune reaction and also to gram staining technique.

Part 2

Option C.

As I mentioned earlier, due to the presence of mycolic fatty acid in its thick outer membrane, the causative agent wont accept the stain. Such bacteria are stained only by acid-fast staining method.

Part 3

Q.1

Option B.

Acid-fast positive bacteria would appear red/ dark pink. They retain carbol fuschin. While acid-fast negative bacteria stains blue.

Q.2

True.

Certain bacteria belonging to the genus Cristispira are known to have a symbiotic relationship with the host namely mollusks which appears to be commensal but not pathogenic.

Q.3

Option A and Option D.

Yersinia pestis and Legionella pneumophila are facultative intracellular pathogen.

Whereas E.coli, Neisseria meningitidis are extracellular pathogen.

Q.4

Option B.

The genera Aquifex represents deeply branching bacteria. They grow under extreme condition namely high temperature and anaerobic state.

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