Reference no: EM133562922
CASE STUDY
Rachel, a 66-year old female presented to her primary care physician complaining of pain, decreased vision in her right eye and a headache
Examination
Rachel's right pupil showed a relative afferent defect. On slit lamp examination there was chemosis, conjunctival injection and some purulent discharge. The cornea was hazy and a small hypopyon was evident. The view into the fundus was impaired due to cells in the anterior chamber and in the vitreous.
After further questioning ...
Rachel's general medical history has been eventful with a recent bout of COVID-19 that hospitalised her and a secondary right eye infection requiring intravitreal antibiotics. Her last injection was two days ago. Usually her vision resolves quickly after the injection but this time it deteriorated rapidly over the last 24 hours.
From the patient's case:
What details would be required to fill a pathological form? complete form
What is the presumed diagnosis?
example: if the presumed diagnosis be endophthalmitis, the pathogen would be Klebsiella pneumoniae and therefore MacConkey agar and blood agar would be required
What relevant tests (horseblood agar, nutrient agar, chocolate agar, marritoal salt agar, SBA, MacConkey Agar) is required (e.g. microscopy/ culture/sensitiity)
What is the speciment transport details and storage instructions
Example: Armies Transport medium with charcoal , (4 degrees, 24hr)
Differential diagnosis and further notes?
Based on patient presentation and your differential diagnosis, what test need to requested to confirm diagnosis? A good starting point for swabs is to use phenotypic testing to determine:
1. the identity of pathogen
2. antimicrobial suspectibility profile to inform treatment option