Reference no: EM133248446

A 59-year old man, presented to the emergency room complaining of fever and chills of 4 days duration, with dizziness over the last 24 hours. He also complained of intermittent diarrhea and constipation over the past 6 months with occasional bloody stool. Fed had been a heavy smoker of 45 years and admitted to drinking alcohol regularly, having two or three beers a night. The patient's breathing was rapid, but his lung sounds were clear. His temperature was recorded as 102.3 C. Fred was hypotensive, tachycardia, and had an appreciable heart murmur. Blood was drawn for a CBC and culture. A stool specimen was collected to test for occult blood, and a chest x-ray was performed.

Results

WBC 9.1

RBC 4.0

Hgb 12.2

Hct 40

MCV 100

PLT 458,000

RBC Morphology

Basophilic Stippling

Hypersegmented Neutrophils

2+ Toxic Granulation

Dohle Bodies

2 NRBC's

The stool was positive for occult blood.

All blood cultures were positive within 24 hours.

Gram's stains from the bottles revealed gram-positive cocci in chains

Subcultures grew readily on BAP and produced small gray gamma-hemolytic colonies

Additional biochemical testing gave the following: catalase, negative: bile esculin agar, growth with black precipitate: growth in 6.5% NaCl, negative: L-Pyrrolidonyl b-naphthylamide PYR test, negative.

Questions:

1. What is the patient's diagnosis and prognosis?

2. Explain lab results and correlate with symptoms.?

3. What other lab results will be helpful in resolving this case?