Question

Case-2:

Complaint:

Five children from the same school presented with abdominal pain and diarrhea (streaked with blood) over a period of 3 days. Upon investigation it was found that those children had recently been in birthday party. Fecal specimen was collected and sent to microbiology lab. Lab report showed presence of pus cells on direct microscopy and non motile bacteria on motility test.

Clinical History: The children are usually healthy. They take no regular medications

a. What is the possible clinical diagnosis?

b. What is the etiological agent and its natural reservoir?

c. How could these infected children be treated?

d. Identify parasitic organism could resemble the same clinical feature of this infection and what laboratory test is used to diagnose it?

e. Identify a virus cause diarrhea with possibility of developing flaccid paralysis? What are the best samples for diagnosis of this virus? What immunological test can be used to confirm this viral infection? Is any prophylaxis available for this virus? If so, explain!

Note: By the way case 2

As you have noticed it combines 3 organisms in one case

Bacteria, parasites, virus

All causing gastrointestinal infection

Answer 1

1) It is a bacterial infection. Examples of the bacteria causing such infection are salmonella,shigella,yersinia,salmonella.

2)Well the etiological agents are the same as written above.

3) Treatment -Bismuth subsalicylate

4)Giardia infection resembles the above clinical features.Antigen testing can be done to confirm the same

5)Polio can cause flaccid paralysis and the best samples for the confirmation are swab from the mouth and stool samples.

Immunological test that are present are Elisa tests,polio virus capture IgM

Prophylaxis is present in the form of vaccination

Children should get 4 doses of polio vaccine

First dose:2 months

Second dose:4 months

Third dose:6 to 18 months

Booster dose: 4 to 6 years