Reference no: EM132322164
Case 1
A 19-year-old male college student presents to the student health department with abdominal pain, diarrhea, and fever. He say that his symptoms started 1 day ago. He has had 10 stools in the past day and has noted blood mixed in with the stool on several occasions. He usually eats at home but reports having eaten chicken in the college cafeteria days ago. He has no history of gastrointestinal (GI) disease. On examination he has a temperature of 37.8°C and appears to be in pain. His abdomen has hyperactive bowels sounds and is diffusely tender but without rigidity, rebound tenderness, or guarding. A stool sample tests positive for blood and fecal leukocytes. Stool cultures are sent and subsequently positive for a pathologic organism. The causative agent recovered from feces was a slightly curved, gram-negative rod.
1. What is the most likely pathogenic organism?
A. Salmonella sp.
B. Campylobacter jejuni
C. Shigella sp.
D. Escherichia coli
2. Case Study 1: What is the term used to describe the type of atmospheric environment best suited for this organism?
A. Microaerophilic
B. Macroaerophilic
C. Increased oxygen levels
D. Increased nitrogen levels
Case 2
A 30-year-old dairy farmer was in good health until the day prior to admission, when he felt chilled and feverish. He developed nausea, vomiting, diarrhea, and lower abdominal discomfort and presented to the emergency room, where he was noted to be lethargic. His vital signs included, temperature of 40°C. His physical examination was remarkable for lower abdominal tenderness to palpation bilaterally. A rectal examination revealed occult blood in the stool the patient was lethargic but had no focal neurological deficits. Of note, his 3-year-old child had been discharged from the hospital 2 days previously with a similar history.
The patient underwent a lumbar puncture because of his altered mental status and fever. Laboratory studies of cerebrospinal fluid (CSF) were within normal limits, and a bacterial culture of CSF was negative.
A stool examination for fecal leukocytes was positive, and stool culture was diagnostic. Biochemical examination of the organism revealed it to be a lactose nonfermenter on MacConkey agar, H2S negative, urea negative, and nonmotile at both 25 and 37°C.
3. What was the most likely source(s) of infection?
A. Contaminated food
B. Contaminated water
C. Pasteurized dairy products
D. Unpasteurized products
4. On the basis of the biochemical reactions, which organism do you think this is?
A. Salmonella sp.
B. Shigella sp.
C. Escherichia coli
D. Campylobacter jejuni
5. Did the person have meningitis?
A. The patient did have meningitis, since he had "no focal neurological deficits"
B. The patient had full nerve, spinal cord, and brain function. "No focal neurological deficits", therefore he did not have meningitis.