Question

A 2-year-old child, Felix experienced an upper respiratory infection 2 weeks prior to this hospital admission. Four days prior to admission, anorexia and lethargy were noted. The patient was seen in the emergency room three days prior to admission. At that time, Felix had a fever of 103.8^o F. Physical examination revealed a clear chest, exudative pharyngitis, and bilaterally enlarged cervical lymph nodes. A throat culture was taken and a course of penicillin was begun. The child’s condition worsened and he became increasingly lethargic; he developed respiratory distress the day of admission. It was noted that the throat culture from 3 days prior to admission had not grown any Group A Streptococci. On examination, Felix is febrile to 102^o F and has an exudate in the posterior pharynx that is described as a yellowish thick membrane which bleeds when scraped and removed. The patient’s medical history reveals that he had received no immunizations.

            1. The patient is admitted to the hospital and treatment is begun. Special cultures of the pharynx were requested that subsequently grew the suspected pathogen. What was this                  pathogen? Explain how you know this.
            2. To cause disease, does this organism invade the bloodstream? If not, how does it cause disease?  

                      3. Fully describe how can this disease be prevented.

Answer 1

1. the pathogen is bacteria called as Corynebacterium diphteriae . this can be concluded as the paitent shows enlarge lymph nodes that eans it must be bacteria as virus do not cuase enlargment of lymph nodes (they are defended by cellular immunity instead of humoral immunity) , also fever was reduced after use of penicillin (an antibiotic) therefore it also indicate it is a bacterial pathogen,as the throat culture was negative for streptococci was negative and an exudate in the posterior pharynx and given that paitent is not vaccinated it proves that is has to be this only.

2. yes it gets absorbed by the blood stream and creates a puesdomembrane at the back of the throat which is the fibrin network where diphteriae cells multiply on the necrotic lession over the epithelial cells at the back of the throat.

?3. it can be prevented by vaccination of the young one . the vaccine administered is usually with combination with other infections vaccines, usually with tetnaus and pertussis , togther called as DPT vaccine. another widely administered vaccine is a pentavalent vaccine Quinvaxem.
?to manage the disease antibiotics can be given like Metronidazole or procaine penicillin G if allergic to penicillin ,rifampin can be precribed.