Question

A 34 year old female with HIV comes to the office due to the appearance of multiple tender nodules on her lower extremities over the past several weeks. The patient tried to squeeze open the lesions, but this led to profuse bleeding with no expression of pus. She works at a pet store in Mississippi and has regular contact with a variety of animals. Skin examination findings are shown below. Biopsy of the lesions reveals large endothelial cells forming vascular channels with a mixed neutrophilic and lymphocytic infiltrate. Immunohistochemical staining for human herpesvirus 8 is negative. On Warthin-Starry Stain there are gram negative bacteria. Infection with which of the following pathogens is most likely responsible for the patient's skin condition?

Group of answer choices

Bartonella henselae

Pseudomonas aeruginosa

Yersinia pestis

Yersinia enterocolitica

Answer 1

Answer option one Bartonella henselae.

Based on given client history , she was immuno compromised, exposing regularly with animals so there is a chance of zoonotic diseases.

Bartonella henselae is a proteobacteria , gram negative strain. ,it is a facultative intracellular microbe that targets red cells ,invaded in the mature blood cells of humans. Ten days after exposing to this microbes symptoms starts with lymphadenopathy. Fever, abdominal pain , have greatest complications for immunocompromised patient.It is formally Rochalimaeam , present with. warthin starry stain on skin, numerous small friable nodule causing obstruction and deformity. On microscopic examination we found lymphocytes,plasma cells, neutrophils.

Yersinia pestis is a gram negative bacteria ,non motile ,rod shaped ,coccobacillus bacteria without spores. It is a facultative anaerobic organisms that cab infect human via he oriental rat flea. Symptoms include lung infection with plague,high fever ,chills chest pain ,rapid breathing.

Pseudomonas aeruginosa is a common encapsulated gram negative bacteria ,rod shaped bacteria that can cause disease in plants and animals ,including human.It commonly affect immunocompromised .

Yersinia enterocolitis is a gram negative bacillus shaped bacteria that causes a zoonotic disease called yersiniosis .