B. A 30-year-old dairy farmer Ralph was in good health until the day prior to ad
ID: 262597 • Letter: B
Question
B. A 30-year-old dairy farmer Ralph was in good health until the day prior to admission, when he felt chilled and feverish. He developed nausea, vomiting, diarrhea and lower abdominal discomfort; he presents to the emergency room, where he is noted to be lethargic. His vital signs include temperature of 104o F, blood pressure of 100/60 mmHg in the supine position and 80/60 mmHg sitting and a pulse of 80 beats/min. His physical examination is remarkable for lower abdominal tenderness to palpation bilaterally. A rectal examination reveals occult blood in the stool. Ralph is lethargic but has no focal neurological deficits. Of note, his 3-year-old son had been discharged from the hospital 2 days prior with a similar history.The patient underwent lumbar puncture because of his altered mental status and fever. Lab studies of the CSF are within normal limits and a bacterial culture of the CSF was negative. Ralph is treated with IV fluids and antibiotics, and his condition improves. A stool examination for fecal leukocytes was positive, and a stool culture was diagnostic. Biochemical examination of the microbe revealed it to be a lactose nonfermenter on MacConkey agar, H2S negative, urea negative, and nonmotile at both 77o F, and 98.6o F. 4.
Based on the biochemical reactions, what genus is it? How do you know this? 5. Ralph's wife and child also had this infection. Was this individual’s vocation important in the epidemiology of this infection in his family? Explain your answer.
Explanation / Answer
there are only two pathogenic lactose nonfermenter bacteria which are Moraxella catarrhalis and Pseudomonas aeruginosa amongst which former one affects upperrespiratory tract and as our paitent is not affects by upper respiratory tract infection it can not be Moraxella catarrhalis. ?Additionaly the biochemical test results are simillar to the biochemical results of the Pseudomonas aeruginosa ?and hence the pathogen genus is Pseudomonas.
??No it is not related to the husband's vocation as the Pseudomonas aeruginosa? epidemiology is assosiated with serious illnessi.e. hospital aquired infections like cystic fibrosis ventilator assosiated pneumonia and other sepsis syndrome.
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