Josephine Sullivan Case Study

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Calhoun Community College *

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220

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Biology

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May 24, 2024

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docx

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Uploaded by jaleasej

Josephine Sullivan MLT141 Microbiology Case Study: C. A., a 21-year-old African American college student comes to the emergency room by classmates. She complained of stiff neck and severe headache with vomiting after taking a nap but pushed it off as studying all night sleeping in chair. Reports that she has been complaining of fatigue, fever and muscle ache times 3 days. States has a small rash on hands and upper torso but admits to changing skin lotion recently. Her classmates report that she seems to become confused at times. She was recently inducted into college sorority and started feeling ill after the induction party. Medical history: seasonal allergies with frequent sinus infections otherwise insignificant. Vitals: BP: 146/80 mmHg, P. 103 Temperature 102.1 degrees F Light sensitivity noted with physical exam. Some confusion when asked time, place, name. Physical Exam: hypertensive, petechiae on forearms and upper torso. Pale complexion. Orders: MRI, CBC with diff, Lumbar puncture with glucose and protein. Started on Levaquin IV and given Acetaminophen 500 mg orally. Procedure: Lumbar puncture (CSF) CBC Value Patient Normal Value * White Blood Cell 21,000 mm3 5000 - 10,000 mm3 Neutrophiles 81% 60- 65% Labs results CSF: Findings Reference range Appearance Hazy Clear Glucose 16 mg/ dl 50-80 mg/dl Total Protein 88 mg/dl 15-45 mg/dl White Blood Cells 1800 mm3 0-3 mm3 Cell Differential 96% neutrophiles 0-1 neutrophiles Gram Stain neutrophiles and gram-negative diplococci no bacteria should be present. CSF is a sterile

1. What is reported by patient history that is striking? a. College student recently inducted into sorority. b. Fatigue, fever and muscle ache for three days c. History of seasonal allergies with frequent sinus infections d. All the above 2. What possible pathogen are indicated? a. Streptococcus pneumoniae b. Neisseria meningitidis c. Haemophilus influenzae d. Listeria monocytogenes 3. What is this patient’s most likely diagnosis? a. bacterial meningitis b. Encephalitis c. Lyme Disease d. Pneumonia 4. What confirmation ID test should be performed? a. Oxidase and carbohydrate utilization b. Catalase and Hemin c. Catalase and bile esculin d. Urease and TSI 5. What patient populations are at risk for infections by this pathogen? a. College students b. Military recruits c. Elderly in nursing homes d. Young children Dx: bacterial Meningitis

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