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The Levaquin treatment caused a mutation to develop in the resistant cells Population replacement of normal flora wtih Levaquin resistant cells due to loss of competition

The Levaquin treatment caused a mutation to develop in the resistant cells Population replacement of normal flora wtih Levaquin resistant cells due to loss of competition

Human Anatomy & Physiology (11th Edition)
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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**Case History for Educational Review:** A patient is admitted to the Emergency Department with a three-day history of severe coughing and fever and is subsequently transferred to the ICU with severe bacterial pneumonia caused by *Streptococcus pneumoniae*. The patient is treated with the fluoroquinolone antibiotic Levaquin (R). Initially, the patient shows improvement; however, the condition relapses, leading to the patient's death on day five of hospitalization. **Medical Findings:** - Cultures are taken on day one and day five. - The isolates from these cultures are identical except for genetic mutations. - *S. pneumoniae* from day one exhibits a point mutation in the *parC* gene, showing susceptibility to Levaquin. - *S. pneumoniae* from day five shows point mutations in both the *parC* and *gyrA* genes, resulting in resistance to Levaquin. - The cause of death on day five is identified as pneumonia and sepsis.
Transcribed Image Text:**Case History for Educational Review:** A patient is admitted to the Emergency Department with a three-day history of severe coughing and fever and is subsequently transferred to the ICU with severe bacterial pneumonia caused by *Streptococcus pneumoniae*. The patient is treated with the fluoroquinolone antibiotic Levaquin (R). Initially, the patient shows improvement; however, the condition relapses, leading to the patient's death on day five of hospitalization. **Medical Findings:** - Cultures are taken on day one and day five. - The isolates from these cultures are identical except for genetic mutations. - *S. pneumoniae* from day one exhibits a point mutation in the *parC* gene, showing susceptibility to Levaquin. - *S. pneumoniae* from day five shows point mutations in both the *parC* and *gyrA* genes, resulting in resistance to Levaquin. - The cause of death on day five is identified as pneumonia and sepsis.
The text discusses a clinical scenario involving a patient who initially showed improvement with Levaquin treatment, as evidenced by a decrease in symptom severity by the third day of hospitalization. However, on day four, the patient experienced a worsening condition, marked by a fever of 104.5°F, progressive hypoxia, and hypotension. The patient ultimately died on the fifth day of hospitalization. A multiple-choice question is posed to explore the potential reasons for the patient's death: 1. The Levaquin treatment caused a mutation to develop in the resistant cells. 2. Population replacement of normal flora with Levaquin resistant cells due to loss of competition. 3. Population increase of Levaquin susceptible cells due to increased nutrients on day 5. 4. Levaquin treatment resulted in population replacement of susceptible cells with resistant cells by day 5. The text presents four options to analyze the reasons behind the patient's deterioration and subsequent death, focusing on possible bacterial resistance mechanisms.
Transcribed Image Text:The text discusses a clinical scenario involving a patient who initially showed improvement with Levaquin treatment, as evidenced by a decrease in symptom severity by the third day of hospitalization. However, on day four, the patient experienced a worsening condition, marked by a fever of 104.5°F, progressive hypoxia, and hypotension. The patient ultimately died on the fifth day of hospitalization. A multiple-choice question is posed to explore the potential reasons for the patient's death: 1. The Levaquin treatment caused a mutation to develop in the resistant cells. 2. Population replacement of normal flora with Levaquin resistant cells due to loss of competition. 3. Population increase of Levaquin susceptible cells due to increased nutrients on day 5. 4. Levaquin treatment resulted in population replacement of susceptible cells with resistant cells by day 5. The text presents four options to analyze the reasons behind the patient's deterioration and subsequent death, focusing on possible bacterial resistance mechanisms.
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