2. Following a particularly dry and windy Summer, a 30 yr old Filipino woman in
ID: 269783 • Letter: 2
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2. Following a particularly dry and windy Summer, a 30 yr old Filipino woman in her third trimester of pregnancy comes to your Paso Robles clinic complaining of extreme low back pain that seems to have worsened over the last several weeks. An x-ray reveals a lesion in her 4th lumbar vertebra. Material from the needle biopsy of the lesion shows spherules containing endospores. a. What infectious agent is causing her infection? b. How could she have avoided catching it? c. Is there a vaccine? d. What personal circumstances make her more vulnerable to the infection? e. Did the weather factor into her becoming ill?Explanation / Answer
And 2 a. Coccidioides immitis, a pathogenic fungus has caused this ailment.
Answer 2 b. She has basically caught infection from the sand may be during the sand bath near the sea. The hyphae or the arthroconidia or arthospores of this fungus are present in the sand, its an air borne pathogen that during the advanced stage of it ms development forms spherules with endospores. So, if she would have avoided this sand bagh then definitely she would have caught the infection.
Answer 2c. Fluconazole, Itraconazole, Ketoconazole are quite helpful in the chronic cases. Research has been going on for this ailment to produce genetically modified medicines as it is becoming quite prevalent these days in the coastal countries.
Answer 2 d. The growth of the arthroconidia in human body is dependent upon the amount of carbon dioxide, high temperature and nutrition. At pregnancy, she must be taking good diet, Deficiency of haemoglobin generally occurs during the pregnancy means less oxyhaemoglobin and more CO2 in the body, all these favorable conditions has made an arthroconidia to grow into a spherule.
Answer 2e. Yes, as said in the above part it requires 3 conditions to grow further. Out of 3, 2 factors are provided by the pregnant women and 1 factor is provided extrinsically, means from outside. Hot weather (high temperature ) favours in fast growth of this fungus. She has been diagnosed at the chronic stage.
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