Question

Bob was hot and sweaty. He’d spent the last hour and a half of a humid July afternoon on his riding lawnmower. “Why am I out here melting when I have three able-bodied sons would could be mowing?” Bob muttered. He decided to head back to the house for an ice cold drink and to draft his 19-year-old son to finish the weekly mowing. About 15 yards from the back of his garage, Bob’s mower lurched, made a horrible noise, and spewed a lot more than grass clippings out the side. “*@#$!” Bob shouted as he cut the motor and jumped off his mower. “Oh great,” Bob said as he crouched down for closer inspection of the problem. “I ran over a stupid rabbit’s nest.” Bob looked up just in time to intercept his youngest son, who had been playing a game on the back porch. “Hold it there, mister,” Bob ordered his son. “There’s nothing out here for you to see.” Davey stopped just before leading over the porch railing. “Aw, but dad, that was really cool! Can’t I come see the bunny bits?” Davey whined. A stern look from his father was all it took for Davey to return to his game. Bob stomped into the garage to retrieve a garbage bag and his best pair of barbeque tongs. He quickly deposited all of the “bunny bits” in the plastic bag, dropped the mess into the trash can, and put the mower away without finishing the job. Bob decided it was a sign that he had done enough mowing for the weekend and he should enjoy a cold lemonade on his front porch swing.

Three days later, Bob woke up with a headache and feeling achy all over. He took a couple of Tylenol and stopped for an extra large coffee on his way to the office. “Maybe a little caffeine will perk me up,” Bob groaned as he booted up his computer and started his busy day at work.

The coffee didn’t help. By mid-afternoon, Bob had developed a persistent, dry cough, chills, and a worsening headache. When he arrived home, Bob skipped dinner and went straight to bed. Patti, his concerned wife, came to check on her husband after feeding their family. Upon taking his temperature (102.4°F), Patti brought Bob some Tylenol and a tall glass of ice water. “Take these,” she said. “They will help with your cough, headache, and fever.” “What about the rest of my aches?” Bob complained. “My muscles and joints are so sore. I haven’t felt like this since I had the flu ten years ago. Leave it to me to get the flu in the middle of the summer.” Feeling sorry for her uncomfortable husband, Patti gently massaged his back as he finally drifted off to sleep. “Hopefully he will feel better after a good night’s sleep,” Patti prayed.

1. Are Bob’s symptoms consistent with the flu? When is “flu season?” (2 pts)

Unfortunately, Bob coughed all night long. By morning he had a fever of 103°F, chest pain, shortness of breath, plus his continuing headache and muscle aches. Additionally, Bob felt he was growing weaker by the minute. Profoundly ill, he let Patti take him to the ER. Dr. Martin ordered a CBC (complete blood count), chest x-ray, a rapid flu test, and a sputum culture. Since Bob’s temperature had climbed to 103.6°F, an antipyretic (fever reducer) was administered and Bob was placed on oxygen to ease his labored breathing. Dr. Martin asked Bob numerous questions about his activities, travel, and exposure to other people and to animals before admitting him to the ICU.

Within 1.5 hours, Dr. Martin had some of Bob’s test results back. His white blood cell count was slightly elevated at 16,000 cells/mm³ and his radiographs showed extensive bilateral infiltrates. Bob’s rapid flu test was negative for infection with influenza A or B viruses, but the Gram stain of his sputum specimen was significant for small, Gram-negative coccobacilli with bipolar staining. Additionally, the laboratory noted that some of these bacteria were found living inside phagocytic cells in Bob’s sputum sample. Dr. Martin immediately initiated broad-spectrum antibiotic therapy to fight this bacterial infection.

2. What is the common medical term used to describe an infection of the lungs? (2 pts)
3. What is a normal WBC count for an adult? What does Bob’s elevated WBC count suggest? (2 pts)
4. What is Bob’s diagnosis? What specific disease is he suffering from and what organism is causing it? Provide your rationale. (5 pts)
5. What is the infectious dose for this highly contagious disease? (2 pts)
6. Dr. Martin also indicated that he is concerned about Bob’s survival. What is the mortality associated with this infection? What complications usually contribute to mortality? (3 pts)

Answer 1

1. Infection of lungs is commonly called pneumonia. Pneumonia which affects the smaller sacs of lung is mostly affected due to bacteria and maybe due to viruses.

2.Normal WBC count for an adult is 4000 to 11,000 cells per micro litres of blood.

WBC count is increased during most of the infections inorder to resist the growth of bacteria by fighting against it with antibodies and certain chemicals.

3.Diagnosis:Chest X-ray,CT scan,skin test and blood test etc.

Tuberculosis is the disease that Bob is suffering and the organism causing this disease is mycobacterium tuberculosis.

4.Infectious dose is 10 bacilli per inhalation.

5.Tuberculosis is the leading cause of death worldwide from a single microorganism. Usually the cause of death will be a lung damage; once a mycobacterium tuberculosis is entered and get started to multiply inside the lungs,the lung will get filled with fluid and gets damaged.Also sometimes if untreated tuberculosis can affect kidney,brain and other vital organs which will be fatal.