Clinical History:This 29-year-old male's illness began 10 weeks prior to death, with an episode of "flu". Two weeks later his urine became "smoky". He was found to have hematuria, albuminuria and elevated BUN (180 mg/dl). He died from a pulmonary embolus. Photos include throat photo, blood agar, and grain stain.What specimens should be taken, aside from blood?What tests should be run? Include both a rapid test option and a lower cost test option.What signs and symptoms should have alerted the patient to come in for testing during or after his viral flu episode?What was the most likely cause to the embolus?No references, just homeworkplease include references

Case History: Male/ 29 years Primary symptoms - FluSecondary symptoms - acute renal failure Death due to pulmonary embolism.1. Blood culture will give a positive finding of the causative organism. Apart from that, a throat swab or oropharyngeal swab will give positive findings by Gram stain and culture. 2. The tests run could include: Gram stain with traditional culture and antimicrobial susceptibility test for identifying the pathogen. A rapid test will be the low-cost option. The Strep Throat Test is a rapid test to detect the presence of Group A Streptococci (GAS), the suspected pathogen in this case. A high-cost (not anymore though) could be a polymerase-chain-reaction (PCR) test on the swab collected. 3. Though during flu, the signs and symptoms are common as in any bacterial or viral flu, once the renal involvement happened, the patient should have contacted the hospital emergency. The hematuria is a sign unmissed and as blood appeared in the urine, the patient and his associates should feel alarmed. Of course, albuminuria and high blood urea are reported by the laboratory but could not be seen or felt by the patient. The presence of blood in the urine following a throat infection should be immediately reported and followed up. 4. Streptococcal toxic shock syndrome is the cause of pulmonary embolism. The clots are usually smaller and multiple and contain live streptococcal bacteria. Ironically, Streptococcus pyogenes produces clot-dissolving enzymes as a virulence factor to gain entry into the body. The clotting is identified as Disseminated Intravenous Clotting (DIC) and is the cause of pulmonary embolism.