Question

CASE STUDY

A 20-year-old construction worker called into the company clinic with a complaint of low-grade fever, malaise, and headache. He was told to take two aspirins every four hours and get back to work. He came in 3 days later. His headache had never completely gone away and was now much worse. His fever was now 40.3°C. In addition, he had developed photophobia and a stiff neck.

1. The stiff neck accompanied by a headache get the young man immediate attention. What is the presumptive diagnosis?
2. The lumbar puncture revealed a glucose level that was low, and a protein level of 220 mg/dl (elevated). This is most indicative of a viral or bacterial infection of the nervous system? Thoroughly explain your choice and explain the results of the lumbar puncture as it relates to the diagnosis.
3. Select ONE possible etiological agent of this type of infection (there are many) and list characteristics of the etiological agent. Give background information on this organism’s microbial characteristics, nutritional requirements, virulence factors, epidemiology, and susceptibility to antibiotics.
4. Discuss how your patient was infected, treatment and long term prognosis.

Answer 1

The patient exhibits the signs and symptoms of meningitis as the patient suffer from the following symptoms :
*stiff neck
*headache
*low-grade fever,
*malaise.

Since the lumbar puncture revealed a glucose level that was low, and a protein level of 220 mg/dl (elevated). It is an Acute Bacterial Infection .

	Acute bacterial	Acute Viral	Acute fungal
Cells	Increased WBC count (neutrophils)	Increased WBC Count(Lymphocytes)	Increased WBC Count(Lymphocytes or monocytes)
Glucose	Decreased	Normal	Normal or decreased
Protein	High	Normal or high	High
Lactate	>35mg/dl	Normal	>25mg/dl

Bacterial meningitis can be caused by a range of bacteria, including:

• Haemophilus influenzae (H. influenzae) type B (Hib)
• Neisseria meningitides (N. meningitides)
• Streptococcus pneumoniae (S. pneumonia)
• Listeria monocytogenes (L. monocytogenes
• Group B Streptococcus

Haemophilus influenzae, a type of bacteria, can cause many different kinds of infections. These infections range from mild, ear infections, to serious, like bloodstream infections.

+Causes:

Haemophilus influenzae disease is a name for any infection caused by bacteria called H. influenzae. There are 6 identifiable types of H. influenzae (named a through f) and other non-identifiable types (called nontypeable). The one that people are most familiar with is H. influenzae type b or Hib.

These bacteria live in people’s nose and throat, and usually cause no harm. However, the bacteria can sometimes move to other parts of the body and cause infection.

+Transmission :

People spread H. influenzae, including Hib, to others through respiratory droplets. This happens when someone who has the bacteria in their nose or throat coughs or sneezes. People who are not sick but have the bacteria in their noses and throats can still spread the bacteria. That is how H. influenzae spreads most of the time.

The bacteria can also spread to people who have close or lengthy contact with a person with H. influenzae disease

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