A 15yr-old girl presents with sore throat, fever, malaise, and difficulty swallo

Question

A 15yr-old girl presents with sore throat, fever, malaise, and difficulty swallowing. Her symptoms have worsened over three days, but throat cultures tor streptococci are negative. After a few more days, her fever got worse, she was u to eat or swallow, she displayed hypotension and a low pulse rate. Her mouth was dry and her tonsils inflamed and enlarged. She has an elevated WBC, 39% PMNs, 49% lymphocytes, and 11% monocytes. Approximately 50% of the lymphocytes looked atypical or abnormal. Significantly elevated levels of immunoglobulins were present, but the platelet count and serum electrolytes were normal. What class of pathogen might you expect the young girl to be suffering from? Explain your rationale. The girl was admitted to the hospital treated for dehydration and administered corticosteroids (anti-inflammatory or immuno-suppressive agents). She improved quickly and was discharged. Based on the above phenotype and knowing that immuno-suppressive steroids improved her symptoms, propose one mechanisms of the pathogen's virulence?

Explanation / Answer

The girl seems to be suffering from rheumatoid arthritis. In this disease, tonsils are enlarged and swollen. Tonsilectomy is one of the treatments of Rheumatoid arthritis. Dehydration also occurs in this disease. It is an auto-immune disease caused by certain oral bacteria and virus. The pathogen starts attacking the joint lining leading to bone and cartilage damage. This condition is quite painful.

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