Chapter 20, Problem 1EDCS

(1)

Summary Introduction

To determine:

What color would the bacterial cells appear in if the sample of the patient’s CSF were gram stained; why the doctors suspected flu rather than melioidosis; why is it unlikely that there will be an epidemic of melioidosis in Norway or Sweden.

Case summary:

Person I was a community college student who got the opportunity to help a professor to do research for a month in Northern Australia’s Kakadu National Park. She did not complain even though hiking the trails is hot and tiring. Things would be better if the thorns did not tear her legs regularly and if it did not seem to rain all the time.

A week later, after her return to Houston, she developed a high fever and general weakness. The blood work and all other signs appeared normal. Suspecting flu, the doctors told her to get plenty of rest and sent her back to home. Two days later, she was intermittently confused and felt drowsy, her breathing was labored, and a small cut on her leg was inflamed and was found to be a pus-filled lesion. She died the very next day following the hospital admission.

She died of an emerging disease called melioidosis, caused by a Gram-negative bacterium, Burkholderia pseudomallei. It produces a toxin that inhibits synthesis of proteins in the infected human cells. It is endemic to the Southeast Asia tropicals and appears to spread into more moderate climes. Person I had been infected either through inhalation or through an inflamed cut on her leg. Even with the treatment, 90% of melioidosis patients die.

(2)

Summary Introduction

To define:

Why the doctors suspected flu rather than melioidosis.

Case summary:

Person I was a community college student who got the opportunity to help a professor to do research for a month in Northern Australia’s Kakadu National Park. She did not complain even though hiking the trails is hot and tiring. Things would be better if the thorns did not tear her legs regularly and if it did not seem to rain all the time.

A week later, after her return to Houston, she developed a high fever and general weakness. The blood work and all other signs appeared normal. Suspecting flu, the doctors told her to get plenty of rest and sent her back to home. Two days later, she was intermittently confused and felt drowsy, her breathing was labored, and a small cut on her leg was inflamed and was found to be a pus-filled lesion. She died the very next day following the hospital admission.

She died of an emerging disease called melioidosis, caused by a Gram-negative bacterium, Burkholderia pseudomallei. It produces a toxin that inhibits synthesis of proteins in the infected human cells. It is endemic to the Southeast Asia tropicals and appears to spread into more moderate climes. Person I had been infected either through inhalation or through an inflamed cut on her leg. Even with the treatment, 90% of melioidosis patients die.

(3)

Summary Introduction

To define:

Why it is unexpected that there will be an outbreak of melioidosis in Norway or Sweden.

Case summary:

Person I was a community college student who got the opportunity to help a professor to do research for a month in Northern Australia’s Kakadu National Park. She did not complain even though hiking the trails is hot and tiring. Things would be better if the thorns did not tear her legs regularly and if it did not seem to rain all the time.

A week later, after her return to Houston, she developed a high fever and general weakness. The blood work and all other signs appeared normal. Suspecting flu, the doctors told her to get plenty of rest and sent her back to home. Two days later, she was intermittently confused and felt drowsy, her breathing was labored, and a small cut on her leg was inflamed and was found to be a pus-filled lesion. She died the very next day following the hospital admission.

She died of an emerging disease called melioidosis, caused by a Gram-negative bacterium, Burkholderia pseudomallei. It produces a toxin that inhibits synthesis of proteins in the infected human cells. It is endemic to the Southeast Asia tropicals and appears to spread into more moderate climes. Person I had been infected either through inhalation or through an inflamed cut on her leg. Even with the treatment, 90% of melioidosis patients die.