CASE HISTORY 2The patient was a 19-year-old male who was brought to the emergency room by his sister. He gave a 24-hour history of dysuria and noted some “pus-like” drainage in his underwear and on the tip of his penis. Urine appeared clear, and urine culture was negative although urinalysis was positive for leukocyte esterase and multiple white cells were seen on microscopic examination of urine. He gave a history of being sexually active with five or six partners in the past 6 months. He claimed that he and his partners had not had any sexually transmitted diseases. His physical exam was significant for a yellow urethral discharge and tenderness at the tip of the penis. (A Gram stain done in the emergency room is shown in Fig. 1). He was given antimicrobial agents and scheduled for a follow-up visit 1 week later. He did not return.QUESTIONS:What pathogen caused the disease? Briefly describe the epidemiology and pathogenesis of this disease.What is the morphology and staining characteristics of the pathogen?What are the virulence factors of this pathogen? What virulence factor(s) made by this organism is responsible for his symptoms?How does the pathogen spread? Why did his partners have a negative history for sexually transmitted disease?What are the possible complications from the disease?How is the disease diagnosed? Discuss:Specimen selection in males and femaleMicroscopic observation. What is the reliability of the Gram stain for establishing the diagnosis in this patient? How reliable is the Gram stain for detection of this organism in cervical specimens from infected women?CultureWhat is the best treatment for the disease?Why do you think this patient was asked to return for a follow-up visit? What is the prognosis for your patient? If this condition is not treated, what are the potential consequences?

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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

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Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...

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CASE HISTORY 2

The patient was a 19-year-old male who was brought to the emergency room by his sister. He gave a 24-hour history of dysuria and noted some “pus-like” drainage in his underwear and on the tip of his penis. Urine appeared clear, and urine culture was negative although urinalysis was positive for leukocyte esterase and multiple white cells were seen on microscopic examination of urine. He gave a history of being sexually active with five or six partners in the past 6 months. He claimed that he and his partners had not had any sexually transmitted diseases. His physical exam was significant for a yellow urethral discharge and tenderness at the tip of the penis. (A Gram stain done in the emergency room is shown in Fig. 1). He was given antimicrobial agents and scheduled for a follow-up visit 1 week later. He did not return.

QUESTIONS:

What pathogen caused the disease? Briefly describe the epidemiology and pathogenesis of this disease.
What is the morphology and staining characteristics of the pathogen?
What are the virulence factors of this pathogen? What virulence factor(s) made by this organism is responsible for his symptoms?
How does the pathogen spread? Why did his partners have a negative history for sexually transmitted disease?
What are the possible complications from the disease?
How is the disease diagnosed? Discuss:
1. Specimen selection in males and female
2. Microscopic observation. What is the reliability of the Gram stain for establishing the diagnosis in this patient? How reliable is the Gram stain for detection of this organism in cervical specimens from infected women?
3. Culture
What is the best treatment for the disease?
Why do you think this patient was asked to return for a follow-up visit? What is the prognosis for your patient? If this condition is not treated, what are the potential consequences?

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