Which

of the following was a critical factor in your choice of diagnosis?

A white male, 18 years of age presented at the emergency room with

a severe headache, vomiting, and a stiff neck with pain running up his back. On

admission, his temperature was 101F. The young man appeared to have trouble

hearing during the nurse’s interview and also seemed to have trouble

concentrating.

The history revealed that he is a wrestler for the local high

school team. He had felt as though he were getting a cold the past few days,

since his last meet in Hicksville. He did not smoke or drink, but he had

attended a party two days earlier thrown by his girlfriend and the other

cheerleaders to celebrate his victory in the sectionals. He had been holding

his weight at 162 for the season, so he ate little and did not drink on the day

of meets (today is a day of the meet).

On physical exam, the physician noticed several areas of small

purplish spots on the skin of the back, thigh and arm. The boy thought those

were from wrestling.

Which of the following is the most likely diagnosis?

C. difficile

is one of the most common infections

found in hospitals although it is a resident microbe of the lower digestive

tract. Why do you think infections occur in hospitalized patients?

What are some of the virulence factors of

C.

difficile

What role did the antibiotics play in Nancy’s

infection?

Consider how did Clostridium difficile

become

an opportunistic pathogen in Nancy’s case. True or false: The antibiotics also upset the normal balance of bacteria in

Nancy’s intestine.

How did E. coli

become an opportunistic

pathogen in Nancy’s case?

Why are females more prone to urinary tract infections (UTIs) than males?

Nancy is an

energetic 66-year old window who walks three miles every day and does water

aerobics three days a week. When she develops an annoying sinus infection, she

doesn’t let it slow her down; she calls her doctor, gets a prescription for

antibiotics, and takes them as prescribed.

After a couple of

weeks the sinus infection is gone, but Nancy notices that she has tourinate

much more frequently than usual. She has a burning sensation while urinating,

and her back aches. Recognizing the common symptoms of a urinary tract

infection, Nancy tries her favorite home remedy of drinking lots of cranberry

juice-after all; she didn’t get to be a healthy 66 by running to the doctor

with every problem.

However, her

symptoms get worse. The pain spreads to her lower back, she develops a fever,

and she feels so weak she can barely get out of bed. Then she notices her urine

is reddish and contains what looks like pus. Alarmed, Nancy struggles to the

phone and calls her favorite niece, Maya, who’s in nursing school. Maya rushes

over, examines her aunt quickly, and calls 911. Maya rides with Nancy to the

emergency room.

The doctor finds

Escherichia

coli

The doctor explains

that women are a greater risk for urinary tract infections than men.

Furthermore, the antibiotics that Nancy took for her sinus infection killed

normal microbiota that hold

Unfortunately, after

two days in the hospital, Nancy becomes nauseated and develops abdominal

tenderness and massive watery diarrhea. A stool test identifies Clostridium

difficile commonly found in the intestinal tract.

What type of bacteria is C. difficile? 

What

is shingles?