Question

1. A 27-year-old woman presents for evaluation of pelvic pain. Over the past week her pain has gotten worse. She has a vaginal discharge and burning upon urination. She takes oral contraceptive pills, she is sexually active and has had multiple partners. She does not have a fever, but she has lower abdominal tenderness. On examination she has a yellow cervical discharge. On the gram stain only white blood cells are seen. A direct DNA probe test came back positive for?

2. A 33-year-old woman presents with a 3 duration of pain upon urination and increased urinary frequency. The urine has a strong odor. She has no fever, no abdominal pain, no back pain, no doischarge or skin rash. She is sexually active and uses oral contraceptives. Microscopic examination of the urine sediment shows white blood cells and numerous gram-negative bacilli.

3. A 52-year-female presents with a four month history of upper abdominal pain associated with nausea. It is worsened by drinking coffee, soda, and alcohol. She has taken over the counter antacids with temporary relief. She smokes and occasionally drinks. Fecal samples are positive for heme. She is anemic. Endoscopic tests show diffuse gastritis and a gastric ulcer.

4. A 25-year-old spelunker who lives in Mississippi has a pulmonary infection that is getting worse.

      His Xray shows an infiltrate or darkened left lobe. Sputum showed pear shaped macroconidia and     

      Staining of colonies showed spores resembling sunflowers in bloom’

5. A 30-year-old immigrant from Central America presents with a mild respiratory infection. He

      only has mild changes in his lungs and gave a positive skin test. Sputum was stained and thick

      walled spherical yeast resembling a mariner’s wheel or a boatman’s wheel were seen.

Answer 1

1. In the first case the women is having STI or sexually transmitted infections caused by Chlamydia trachomatous.

The symptoms shows that the infection may be caused by Chlamydia trachomatis or Neisseria gonorrhoeae. But the gram staining results tells that it is Chlamydia trachomatous because although Chlamydia has gram negative cell wall it doesn't give gram stain test . Gram staining shows only WBC.

Neisseria gonorrhoea will give typical gram negative intracellular diplococci staining on gram staining.

The direct DNA probe test could detect the presence of Chlamydia trachomatous DNA in the swab

2. In this case the women is having urinary tract infection or UTI. The gram negative bacilli detected in urine is E. coli and it causes UTI.

3. This case the patient is having the H. pilori bacterial infection. The symptoms clearly describes the infection. It can lead to both iron deficiency and pernicious anemia, gastric problems, blood in stool etc. Stool antigen detection test can be done to confirm the presence of bacteria.

4. The patient is having a fungal infection called Histoplasmosis. It is caused due to inhalation of the spores of the fungus Histoplasma capsulatum. Tuberculate macroconidia mycelia is the morphological feature of this fungus.

5. In this case the patient is having a topical fungal infection called Paracoccidioidomycosis. It is caused by the fungus Paracoccidioides. This fungus is mainly seen in parts of Central and South America.