Extracted text: MODULE 5 BACTERIOLOGY CASE STUDIES Instructions: Read the following cases and answer the questions accordingly. Type your answer after each question. Case 1 A 34-year old male patients arrives at a local hospital. He felt completely unwell, has a fever, and he lost over 7 kg in the last month. He also suffers from a severe cough with rust-colored sputum. His doctor requested for a chest X ray and sputum sample. During interview, it was revealed that the patient tested positive for HIV a year ago. A tuberculin skin test is then ordered. For three years, he had been living with two roommates. Before that, he lived with another roommate who had tested positive for TB 6 months prior to onset of the patient's symptom. Laboratory tests were also ordered for his two roommates and the results are summarized below: Roommate 1 Roommate 2 Sputum HIV Negative Negative Positive Negative Negative Positive Tuberculin test 1. Why was chest X ray and sputum sample ordered? 2. Based on the symptoms and laboratory results, from what infectious disease does the patient suffer? What is the agent? How did the patient contract the disease? 3. Why is the infectious agent more virulent in HIV-infected patients? 4. Why did the roommates tested positive for Tuberculin test? Case 2 The patient, a 31-year old female is brought in the hospital emergency room complaining of excruciating pain in her right leg, she had difficulty moving. Assessment on her lower leg indicates trauma and the skin is greenish blue. Further examination indicates a crackling sound in her lower leg. A week ago, the patient had a serious mountain biking accident and several deep cuts to her leg. The physician prescribed her with antibiotics. When she was taken to the operating room, a necrotic muscle was discovered. Tissue sample was collected and Gram-positive rods were identified. 1. From the emergency room findings, what disease does the patient have and what bacterium is responsible for the infection? 2. What physical conditions of growth should be used when incubating the blood culture? 3. Since the patient has a necrotic tissue, what other possible treatment or intervention may be given aside from antibiotics? 4. What can be done to slow down or arrest the growth of the infecting microorganisms?
Extracted text: Case 3 On January 15, a 10-year old girl visited by her pediatrician for fever, malaise, painful left underarm lymph node and skin sloughing off her left ring finger. 1. What diseases are possible for this 10-year old girl? Intermittent fever and enlarged lymph node persisted for 49 days. Biopsy of the left axillary lymph node revealed a Gram-negative bacilli. Her pediatrician knows that she loves to play with her cat, often cuddling it. 2. What is likely the source of infection? Discuss thoroughly mode of transmission. 3. Provide the treatment regimen for this bacterial infection. Case 4 JL a 25 year-old college wrestler goes to school clinic with swollen, red thigh. It is warm and tender when touched. He was given co-trimoxazole. After 3 days, he returns and his thigh had gotten worse with broader area of redness. He is later diagnosed with cellulitis. The pustule is opened and drained and sent to the laboratory for Gram staining and a coagulase test on the culture. The results of the Gram stain and the coagulase test are shown in Figure A and Figure B, respectively. Negative control Isolate from patient LM 5 um FIGURE A FIGURE B 1. From the results of Gram staining and coagulase test, identify the cause of infection. 2. Enumerate at least 3 factors which might have contributed to transmission of bacteria to JL. 3. Enumerate treatment options for JL's case.