Question

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!

Note: By the way case 2

As you have noticed it combines 3 organisms in one case

Bacteria, parasites, virus

All causing gastrointestinal infection

Answer 1

a.The most possible diagnosis is Gastroenteritis or food poisoning caused by consumption of infected meat. Signs and symptoms will develop within 8-24 hrs after consumption characetrized by abdominal pain, vomiting and  diarrhea .

b. Clostridium Perfringes is a non-motile rod shaped bacteria causing food poisoning. Clostridium perfringes is the normal inhabitant of the large intestines of the human beings and animals. It is found in feces and it contaminates the skin of perineum ,buttocks and thigh. The spores are commonly found in soil, dust and air

c.The illness is self limited and the recovery occurs within 24-48 hrs. Oral rehydration therapy should be given unless vomiting is present. In case of vomiting, antiemetics and fluids are replaced intravenously.

The drug of choice is IV metronidazole 8th hourly for 24 hrs . As mixed aerobic and anearobic infections are usual, a more broad spectrum antibiotics prophylaxis such as combination of metronidazole, gentamicin and amoxycillin is advisable

d.Protozoas such as cryptosporidium,Giardia intestinalis and cyclospora cayetanensis most commonly cause diarrhea and other intestinal symptoms. Diagnosis is confirmed through laboratory examination of fecal samples