A 30-year-old rancher was admitted to a hospital on February 12 because of a two-day history of headache, chills, and 40 degree Celsius fever. Before he was admitted, he began vomiting. During his admission it was found out that he has an orange-sized swelling in the left axilla. A laboratory analysis was administered using lymph-node aspirate and smear of peripheral blood, the result was reported to contain gram-positive cocci, often in pairs. Due to this situation he was given cefoxitin. The patient was acutely ill. Within a few hours of admission, he had a cardiopulmonary arrest. During resuscitation efforts, he vomited and aspirated his vomitus; a chest X-ray showed bilateral infiltrate. The patient was also bled from several body sites. Six hours after admission the patient died. Based on data given, the patient had trapped, killed, and skinned 3 kit foxes, 4 coyotes, and 1 bobcat. The patient cut his left hand shortly before skinning the bobcat on February 7. After his death, biochemical testing of a gram negative rod isolated from blood cultures identified the etiology as Enterobacter agglomerans. Questions: Identify the following periods: incubation, prodromal, illness, and decline. Identify the etiologic agent of this disease. Briefly explain how you arrived at your conclusion. What microbiological tests would you perform to verify the etiology? How might the patient have been treated between February 7 and 12? What special precautions needed to be taken by the hospital and mortuary personnel?
A 30-year-old rancher was admitted to a hospital on February 12 because of a two-day history of headache, chills, and 40 degree Celsius fever. Before he was admitted, he began vomiting. During his admission it was found out that he has an orange-sized swelling in the left axilla. A laboratory analysis was administered using lymph-node aspirate and smear of peripheral blood, the result was reported to contain gram-positive cocci, often in pairs. Due to this situation he was given cefoxitin. The patient was acutely ill. Within a few hours of admission, he had a cardiopulmonary arrest. During resuscitation efforts, he vomited and aspirated his vomitus; a chest X-ray showed bilateral infiltrate. The patient was also bled from several body sites. Six hours after admission the patient died. Based on data given, the patient had trapped, killed, and skinned 3 kit foxes, 4 coyotes, and 1 bobcat. The patient cut his left hand shortly before skinning
the bobcat on February 7.
After his death, biochemical testing of a gram negative rod isolated from blood cultures identified the etiology as Enterobacter agglomerans.
Questions:
Identify the following periods: incubation, prodromal, illness, and decline.
Identify the etiologic agent of this disease. Briefly explain how you arrived at your conclusion.
What
How might the patient have been treated between February 7 and 12?
What special precautions needed to be taken by the hospital and mortuary personnel?
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