In the early fall, a neonatal nurse n a large metropolitan hospital became ill with a cough and fever. His physician believed he had seasonal allergies and so treated him with cough suppressant, antihistamines, and aerosol steroids. He returned to work in the hospital’s nursery.
Three weeks later, his condition had worsened; his symptoms were complicated by shortness of breath and bloody sputum. Upon further questioning, his physician noted that he was working in the United States on a work visa and was a native of South Africa. He had a positive skin test for tuberculosis (TB) but had always believed this was his body’s natural reaction to the TB vaccine he had received as a child. His chest X-ray films in the past had always been clear of infection.
This time, however, his sputum smear tested positive for acid-fast bacilli. He was diagnosed with active tuberculosis and began a standard drug regimen for TB. He was restricted from work and placed in respiratory isolation for six weeks, but during the three weeks that he had continued to work in the nursery, he exposed over 900 obstetric patients, including 620 newborns, to TB, an airborne infectious disease.
- 1. How can private physicians quickly assess their clients for the possibility of an infectious disease?
- 2. What policies should be in place at hospitals to protect patients from exposure to infectious staff members?
- 3. How could doctors’ offices improve public knowledge and protect the public from tuberculosis and other infectious diseases?
Want to see the full answer?
Check out a sample textbook solutionChapter 14 Solutions
Microbiology With Diseases By Taxonomy (6th Edition)
- Several persons working in an exercise gym acquired an acute diseasecharacterized by fever, cough, pneumonia, and headache. Treatmentwith erythromycin cleared it up. The source was never found, but anenvironmental focus was suspected.a. What do you think might have caused the disease?b. People in a different gym got skin lesions after sitting in aredwood hot tub. Which pathogen could have caused that?arrow_forwardA 30 year old male patient who was a contractor and building inspector in the Greater Accra region complained of difficulty breathing and was admitted to the Greater Accra Regional hospital with severe respiratory disease. The Physician noted a high fever and cough. Two days before, the patient had inspected an old warehouse, abandoned and infested with rodents. The patient was given intravenous antibiotics, but 2 days into therapy the pneumonia worsened and he developed pulmonary edema. a) What are the conditions under which Gram positive bacteria can appear Gram negative?arrow_forwardYour family knows you're a student nurse and frequently asks for your advice. Your brother inquires about his cough, which he has had for two weeks. He's coughing up mucus now, and he thinks he's unwell. They claim it's bronchitis. He wants to know if the amoxicillin he saved from a previous infection should be used. What do you think you should say to your brother? A patient with streptococcal sore throat is given penicillin for two days as part of a 10-day treatment plan prescribed by the doctor. He then feels better because he feels better saves the rest of the penicillin for a later date After three more, he has a painful throat relapse after a few days. Discuss what might have caused the relapse. What is the importance of studying the variety, sequences, and amounts of mRNA produced in the cell?arrow_forward
- A group of patients entered the hospital unconscious. All patients are employees of a chemical plant, where mass poisoning with cyanide compounds occurred. Questions: 1. The development of which kind of typical pathological process (TPP) is initiated by intoxication with cyanides? 2. Define this TPP. 3. What kind of TPP according to the pathogenetic classification has developed in patients? 4. Describe the mechanism of formation of this type of TPP. 5. List the changes in blood gas composition and pH at this form of TPP. 6. How can you explain these changes in blood gas composition and pH? 7. What kind of tissue cell death is typical in this case?arrow_forwardA serological test methods was conducted to determine typhoid fever using serum ( Widal test).Determine the bellow outcome; a.i) Interpret the results and it's limitations. ii) suggest the quality control observed in performing the test.arrow_forwardThe mother of a 6-year-old child brings her daughter to the pediatrician's office because she has had a sore throat, cough, and fever for several days. She reports a fever up to 104°F that worsens at night, but seems to respond to treatment with acetaminophen. The child has not been eating or drinking well because she says, "it hurts to swallow." She is ill appearing, and does not seem interested in playing with the toys that are in the examination room. The physician notes a thick, white exudate on both of the patient's tonsils, which also seem enlarged. A throat culture and complete blood count with differential is ordered. 1) The patient's mother expresses concern about her daughter's fevers. She states that the fevers are a sign that her child is unable to fight this infection. What is a proper response to these concerns? A) It is impossible to determine exactly why she is having these fevers. Doctors call this a fever of unknown origin. B) Fevers are a natural response by the…arrow_forward
- A twenty-nine year old male presents to the ER complaining of headache, dizziness, fever, and a rash on his thigh that has since disappeared. Ten days earlier, he went camping and fishing in upstate New York with his old fraternity brothers. Physical exam remarkable for right facial palsy. EKG shows a heart block. What is the most likely diagnosis? What is the most likely offending agent? How was this organism named (i.e., what is the significance of this organism’s name)? Who serves as the reservoirs for this disease? Who serves as the vector for this disease? What is the treatment of choice?arrow_forward"Imagine you are a young oral hygiene student about to see your dental patient who turns out to have carious lesions on their teeth, the patient informs that the problem runs in the family. Patient X (20 years old, identifies as other) complains of dull pain on the posterior teeth. They describe the pain as sharp but sometimes dull. The pain comes and goes depending on the weather. Patient is asthmatic, lactose intolerant, allergic to penicillin and pollen, uses corticosteroid inhaler, the last asthma attcack was last month triggered by flu. On examination patient has plaque index of 80% and bleeding index of 95%, gingiva appears edematous, red, stippled and consistency is firm. Hard tissue examination- questionable caries on 46, carious lesion involving the dentine (not painful) on 37 and painful 26 with deep and large carious lesion. Deep fissures on 16, 25, 47, 44. The question is how would you approach the problem highlighted in the scenario and how would you manage (treatment…arrow_forwardA 38 year-old woman went to a hospital and complained of a non-productive cough and dyspnea, which has progressed over two weeks. Based on physical examination, she was pale, diaphoretic and in acute respiratory distress. According to her, she had sexual contact with his partner for the past weeks. The physician ordered laboratory tests and results revealed that the CD4 count was significantly low. QUESTIONS: 1. What might be the predominant antibody present in the patient’s serum and why?arrow_forward
- You are caring for a 5-year old with lethargy and a fever of 103 F. Lungs sound are clear but the child complains of a very sore throat prior to going to bed. During transport, you observe copious secretions. Which of the following do you suspect? A) Pnemonia B) Croup C) Bacterial Tracheitis D) Epiglotisarrow_forwardYour 3-month-old son is taken to the emergency room because he has a fever and difficulty breathing. The child is admitted to intensive care because the doctor thinks he has a type of pneumonia whose name you do not recognize. The doctor reports that the hospital has seen a dozen pediatric cases of this pneumonia in the past week. The doctor swabs your son’s nose but says the results won’t be back for several days. In the meantime, they will give supportive therapy, including an inhaled spray, but no antibacterial drugs. The doctor feels sure the child will recover. 1. What kind of pneumonia is it? 2. Why aren’t they giving him antibacterial drugs? 3. How can the doctor be sure what’s causing the pneumonia if she doesn’t yet have test results? 4. Has the other child (a 3 years-old) been exposed to the infection?arrow_forwardThe patient was an 80-year-old female who 10 days previously had had a cystocele repair performed. At the time of the hospital admission, a urine culture was obtained and revealed >100,000 CFU/ml of an Escherichia coli strain that was susceptible to all antimicrobial agents against which it was tested. Postoperatively, she began a 7-day course of oral cephalexin. She was discharged after an uneventful postoperative course of 3 days. Ten days postoperatively, she presented with a 3-day history of diarrhea. The patient noted multiple watery, loose stools without blood, crampy abdominal pain, and vomiting. She presented with a temperature of 38.2 degrees C, pulse rate of 90/min, respiration rate of 20/min, and blood pressure of 116/53mm Hg. Her white blood cell count was normal, but a large number (53%) of immature polymorphonuclear cells were seen. Physical examination, electrolytes, liver enzymes, and lipase were all within normal limits. Cultures for Salmonella, Shigella, Yersinia,…arrow_forward
- Microbiology for Surgical Technologists (MindTap ...BiologyISBN:9781111306663Author:Margaret Rodriguez, Paul PricePublisher:Cengage LearningHuman Physiology: From Cells to Systems (MindTap ...BiologyISBN:9781285866932Author:Lauralee SherwoodPublisher:Cengage Learning