Question

In: Biology

You are doing rotation in hospital's clinical laboratory. A sample of cloudy cerebrospinal fluid (CSF) from...

You are doing rotation in hospital's clinical laboratory. A sample of cloudy cerebrospinal fluid (CSF) from suspected meningitis case arrives and you are told to gram stain it and then plate it on blood agar and chocolate agar. In gram stain you find gram negative bacilli of varying size and shape. You also find lot of bacteria inside phagocytic cells. They are not diplococci.

Later charge nurse tell you the patient, a 3 year old girl, has not received any childhood vaccinations.

1. what is most likely causative agent .How do you know?

2.Explain your results on blood and chocolate agar.

3. Why is the fact that agent is not diplococci significant.

4. Give background info on the causative agent. Also explain what is causing the cloudiness in the CSF fluid.

5. Is this type of infection most often accompanied by increased PMNs, or increased lymphocytes. Explain.

6. Give detailed info about your choice organism: microbial characteristic, nutritional requirements, and growth characteristics(i.e facultative anaerobe, acidophile, capsule forming, lophotrichous flagella..)

Expert Solution

1.H. influenza is the causative agent. It is gram negative coccobacilli(intermediate shape between cocci n bacilli) that causes infections in non vaccinated children under 5 yrs of age

2.In chocolate agar H.influenza forms colonies that are smooth,grey or colorless with a sentinal odour

But it grows poorly in blood agar, growth is seen around colonies of other bacteria that has hemolysed RBCs.It shows satellitism

3. Meningitis is caused by H.influenza and Meningococci.

Meningococci is a diplococci so the statement that the bacteria is non diplococcal can eliminate Meningococci.

4. H.influenza is a pleomorphic,gram negative coccobacillus that causes meningitis,infection of eye, respiratory tract,throat,blood stream.They spreads by person to person contact or through aerosol

The clouding of CSF is due to increased WBCs and RBCs due to the infection

5. Increased PMNs are seen in bacterial infection, they are trying to eliminate the pathogen.But H.influenza is resistant to phagocytosis by PMNs.Elevated PMN levels are seen.

6. It is facultative anaerobic capnophilic pathogen,non motile and basophilic in nature.

Some strains of H.influeza has a polysaccharide capsule n some are non encapsulated forms are more virulent.

It is cultured using CSF/blood/sputum It is gram negative, grows on chocolate agar, poor growth in blood agar, oxidase and catalase positive The grows by taking up hemin n factor V from blood.It shows Satellitism.

It is also detected using Latex agglutination test(LAT).

gladiator answered 2 months ago

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