Reference no: EM132704736
Arjun Chopra had had a long week. At 56, he was just too old for this job anymore! They had unloaded three containers of saris in Durban, another two in Rio de Janeiro. Now they were headed to Havana and it was clearly time for him to retire. He just had to last one more week and he would be home in his birthplace, Patiala, India.
One of his shipmates said he looked pale and felt his forehead. "You better go to the ship's doctor, man." Arjun's pounding headache almost blurred his vision and the stomach cramps made it hard to walk, but he managed to get to the ship's doctor's office with a little determination. The doctor put him on bed rest in the clinic after he discovered Arjun had a fever of 103°C.
When the doctor came in the next morning, Arjun was scratching at his skin and had soiled the bed. He was delirious and raving about how much he missed his wife. He begged her forgiveness for the affairs he'd had. To sooth him, the doctor told him all was forgiven. But since Arjun appeared to be getting worse, they put him in medical isolation. Only the doctor could come and go from the room.
The next morning Arjun had developed a vesicular rash that scabbed over within 24 hours. And one day later he had a horrible dry cough and found breathing difficult. The Cardio Tech alarm called the doctor into Arjun's room four days short days after he had presented with symptoms. Resuscitation was not successful. The doctor would have to write his wife.
1. You work in the morgue in Havana as a forensic pathologist. Given Arjun's risk factors, possible exposures, and symptoms, what are the five most likely infectious agents (names, specific species) that killed him? Please explain your reasoning (multiple right answers if you can support why it's likely).
2. You analyzed the blood work that the ship's doctor had performed. This helped to narrow down possible causes of Arjun's death. How did you know this?
- Platelets - 29 x 109/L
- C3b/C4b - 2.4 g/L and 2.1 g/L respectively
- Atypical lymphocytes - 21%
- Neutrophils - 10.0 ×10 9/L
- Lymphocytes - 5.8 ×10 9/L