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Case-2: Complaint: Five children from the same school presented with abdominal pain and diarrhea (streaked with...

Case-2:
Complaint:
Five children from the same school presented with abdominal pain and diarrhea (streaked with blood) over a period of 3 days. Upon investigation it was found that those children had recently been in birthday party. Fecal specimen was collected and sent to microbiology lab. Lab report showed presence of pus cells on direct microscopy and non motile bacteria on motility test.
Clinical History: The children are usually healthy. They take no regular medications
a. What is the possible clinical diagnosis?
b. What is the etiological agent and its natural reservoir?
c. How could these infected children be treated?
d. Identify parasitic organism could resemble the same clinical feature of this infection and what laboratory test is used to diagnose it?
e. Identify a virus cause diarrhea with possibility of developing flaccid paralysis? What are the best samples for diagnosis of this virus? What immunological test can be used to confirm this viral infection? Is any prophylaxis available for this virus? If so, explain!

Solutions

Expert Solution

a. Possible clinical diagnosis is BACTERIAL DYSENTERY.

Because it is commonly results from the consumption of contaminated foodbor water. The main symptoms are abdominal pain and diarrhea.

here non motile bacterias are found in the test, which means shigella is present .

b. Etiological agent

Shigella.

They are highly host adapted organisms.

HUMANS are the natural reservoir of shigella.

c. Treatment

CIPROFLOXACIN, CEFTRIAXONE, and PIVMECILLINAM are the currently recommended drugs by WHO for dysentery treatment in children.

d. A parasytic organisam called ENTAMOEBA HISTOLYTICA causes AMOEBIASIS also called AMOEBIC DYSENTERY.

Lab tests:

*stool samples

*liver function tests

*PCR ASSAY can also be used for dettection of E. Hystolytica

e. Virus:Rota virus.

Causes diarrhea and may cause flaccid paralysis.

Diagnosis sample:Can be detected in stool samples.

Confirmation test:ANTIGEN DETECTION IMMUNO ASSAYS or REVERSE TRANSCRIPTION POLYMERASE CHAIN REACTION.

Prophylaxis:

There is a rotavirus vaccine for prophylaxis of ingants against rotavirus gastro enteritis.

It is a live attenuated monovalent vaccine(rotarix) , containing human rota virus strain.

Rota Teqis given 3 doses at age 2 months, 4 months, and 6 months

Rotarix is given in 2 doses at ages 2 months and 4 months

Both vaccines are given orally


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