Question

Case Description:

A 65-year-old male presents with a high fever, headache, extreme prostration, a nonproductive cough, and severe breathlessness. He had been receiving chlorambucil for treatment of chronic lymphocytic leukemia (CLL) and was in an extremely debilitated state. The patient exhibited fever, tachypnea, cyanosis, conjunctival congestion, and pharyngeal inflammation. Rales and wheezes were heard on auscultation over both lung fields. He also had splenomegaly and lymphadenopathy (due to CLL). No organisms were seen or cultured from sputum. A chest X-ray showed bilateral, diffuse interstitial infiltrates suggestive of atypical pneumonia. The patient was placed on amantidine, ventilatory support, antipyretics, and IV fluids.

Questions:

1. What virus is causing this patient’s respiratory infection?

2. Why were no organisms seen or cultured in the lab?

3. What could this patient have done to prevent this illness?

4. How many genomic segments are present in this virus?

5. Where in the world do most new strains of this virus originate?

Extra Credit:

What is the cellular receptor for this virus?

Answer 1

1.The Epstein barre virus is causing this patient's respiratory infections. The patient may have any Herpes zoster or herpes simplex infection earlier which can lead to viral pneumonia in chronic lymphocytic leukemia.

2.The diagnosis is made through arterial blood gas,CT chest or by lung biopsy so culture is not done

3.This could have been prevented by proper respiratory hygiene, regular check up ,taking medication as prescribed.

4.The genomic segments of this virus are there is 86 open sequence, 4 strains,It containsctwo DNA.

answered by: anonymous