Nate lives an exciting life. His part of Kentucky is beautiful, and he has oppor

Question

Nate lives an exciting life. His part of Kentucky is beautiful, and he has opportunities for adventure with his friends in Boy Scout Troop 138. They have been hiking, climbing, backpacking, and mountaineering and just 10 days ago had spent all night in a cave deep below the town. After watching what seemed like millions of bats rush and swoop out of the cave, the troop had entered the cavern system through another entrance - a “squeeze entrance.” Nate wasn’t sure what a squeeze entrance was until he had to inch forward for over a hundred feet with his arms stretched in front of him, pulling with his fingertips as his back scraped the ceiling. That had been the worst part. But, after clearing the entrance, the teenagers had explored, scrambled, and crawled the whole night. They had even eaten underground. It was extreme, though it was a little spooky—with bizarre geological formations, pools of ice-cold water, and total darkness—but the guys were still talking about the time they stayed up all night inside the Earth.

Today, though, Nate doesn’t feel so excited. His nonproductive coughing hurts; he likely has a fever, though he feels cold; and he has red bumps on the skin of his legs. His dad takes him to the doctor, who prescribes a medicine that neither Nate nor his parents had heard of—keto-something.

What is the name of the antifungal drug that Nate is taking?

Part C

How likely is it that other scouts were infected during the caving camp out?

Part D

What was the source of the infection?

Part E

What tools would the doctor use to diagnose this disease?

Explanation / Answer

Part A: What is the name of the antifungal drug that Nate is taking?

Answer: Doctor has prescribed Nate and antifungal antibiotic called Ketoconazole. Ketoconazole is belongs to Azole group which inhibits the growth of parasite/pathogen fungus.

Part C: How likely is it that other scouts were infected during the caving camp out?

Answer: All the people in troop were in contact of environment containing soil contaminated with bat dropping. In such environment there is fungus evolution called Histoplasma. If one breathe in such environment he is likely to inhale the spores of the fungus in subject and will get infection and disease called as Histoplasmosis. Although most people who breathe in the spores don’t get sick, but in some people, such as those who have weakened immune systems, the infection can become severe. So for the question right answer will be “a” - It is highly likely that 90% or more of the scouts will show evidence of infection (antibody formation). Only a small percentage of these will get sick.

Part D: What was the source of the infection?

Answer: As explained in answer 2 the fungus produces spores so the right answer will be “c” - inhalation of spores from the bat guano

Part E: What tools would the doctor use to diagnose this disease?

Answer: identification of the budding yeast in KOH-prepared samples of skin scrapings or sputum from the patient – Is the best method to diagnose the disease Histoplasmosis.

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