Question

1. A 3-year-old male infant is brought to the emergency room in the middle of February with fever, vomiting and diarrhea for the past day. He has not been able to keep anything down and he has a watery diarrhea. He goes to daycare and many of his classmates are also sick with the same symptoms. He has tachycardia and a fever (100.2 F). His eyes appear sunken, he has active bowel sounds and his stool is watery and pale. His feces was negative for blood and white blood cells.

2.

On an autumn day a number of people became ill working at the Widget Company. It

                is an industrial plant in the heart of Cincinnati, Ohio. Their symptoms ranged from

               simple coughing and other respiratory symptoms to pneumonia. At least one of fifty

                people showing symptoms died. The company voluntarily closed the building upon

               recommendation from the health department. After all of the water and cooling systems

            at the plant were evaluated and disinfected, it reopened and no new cases were

            reported. What is the causative agent at the factory?

3.

A 35-year-old nurse, developed symptoms of cough, myalgias, headache made worse

            by coughing, substernal chest pain, and high fever. She suspected _________?______

            because an outbreak was in progress and she had recently cared for several patients

            with similar symptoms. During the next three days, she was bedridden because of

            weakness and a persistent fever of 103 F. The symptoms gradually resolved over the

            next few days without specific treatment. After 7 - 10 days, she was able to resume her

            usual activities.

Answer 1

Answer with explanation:

1) 3 year child is likely to be suffering from viral gastroenteritis.Common virus in this age group is rotavirus.

As is clear from the symptoms child is suffering from gastroenteritis, absence of blood and white blood cells in stool point towards viral cause.

Rotavirus is member of family Reoviridae. It effects children worldwide particularly of the age group of 3- 5 years. Infections are more common in day care settings. Cases peak during winter and spring seasons. Clinical features range from subclinical infection to severe gastroenteritis leading to life threatening dehydration. Diagnosis can be confirmed by viral RNA detection.

2) Causative organism is Legionella pneumophila.

Natural habitat of Legionella pneumophila is aquatic body. It has been linked to devices filled with tap water, whirlpools, humidifiers,air conditioning systems. These pathogens are transmitted in water droplets originating from humidifiers, shower heads or air cooling systems causing Legionnaires disease or Legionella pneumonia. Symptoms are cough, fever shortness of breath. Gastrointestinal symptoms such as abdominal pain, diarrhoea and mental confusion are also common. It may have severe complications which include myocarditis, endocarditis and pancreatitis and may cause mortality.

3) Viral pneumonia.

Influenza, parainfluenza, coronavirus and respiratory syncytial virus are common viruses responsible for viral flu or pneumonias. Viruses can cause sudden outbreak due to continuous antigenic changes in the structure. They are easily transmitted from one person to other through respiratory route.Symptoms are cough, cold, fever, malaise and headache. Fever subsides in 5-10 days. Viral pneumonias are usually self-limiting and usually require only supportive treatment. Diagnosis can be confirmed by RT-PCR test.