Question

A 27-year old white female presented herself at her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender abdomen and complained of headache, stiff neck and backache with diarrhea. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the University in her town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of flies in the area. She felt sick the last day there after eating some canned food, as there was no cooler there. You had no time for culturing, as you need to take action fast. What type of disease she could have based on the symptoms and why? You are not required to name a specific disease but a general type of disease. Naming a disease means you have answered the question wrong. What features are not critical to your diagnosis from the case & why? What further steps should be taken to precisely identify the case & why? What microbes you will not consider and why [name 4]. What steps would you take to ensure that the patient is stable till diagnosis is confirmed; explain why would you do this?(microbiology)

Answer 1

Headache, stiff neck, fatigue and lack of ability to concentrate are symptoms of Meningitis (cause could be working with animals lead to listeria infections). Fatigue, tender abdomen, back ache and diarrhea are symptoms of botulism (cause could be spoiled canned food) but botulism donot cause fever.Salmonella & E.coli can be ruled out as they donot cause stiff neck or confusion. Broad spectrum antibiotics & IV fluids should be started as it is best treatment for any bacterial meningitis or food bourne infections and later we can order for Blood/spinal fuild culture.