Case-2: A 56 year-old male was presented to the Emergency Department with fever, shortness of breath,...

Case-2:

A 56 year-old male was presented to the Emergency Department with fever, shortness of breath, and cough. His symptoms began approximately 2 days ago and are continuous, steadily getting worse.

History:

He is a known HIV patient under antiviral treatment.

Physical exam:

Temperature: 38.5C Blood Pressure: 120/76

Blood culture: No bacteria growth

Sputum culture: Normal flora of upper respiratory tract is grown

Rapid flu PCR: Negative

India ink stain of broncho-alveolar lavage fluid: capsulated oval shaped organism

What is the possible clinical diagnosis.? Crytococcosis

b. What is the possible causative organism? Yest cryptococcous neoformans

c. What is the normal host of this organism?

d. What is the mode of transmission of this infected organism?

e. List two other infections caused by this organism in HIV-infected patients.

Meningitis, pneumonitis.

f. What other lab tests could be used to further confirm this infection?

I want to solve the rest of the questions

Solutions

Expert Solution

c] C neoformans are found in both plants and animals. Their normal hosts are birds, like pigeons.

d] They spread in humans on coming in contacts with pigeon or any other carrier bird's droppings or by eating contaminated raw fruits.

e] When the pathogen spreads in the body, it targets the central nervous system, specially the brain. Their other target organ is the respiratory system. So, they mostly cause diseases like cryptococcal meningitis, affecting the brain and diseases of the repiratory tract, the most common being pneumonia.

f] Lab test for detecting cryptococcal meningitis includes testing the blood serum and cerebrospinal fluid for the presence of the antigen. Lateral flow assay screen helps to detect the presence of the antigen.

CSF culture is considered a very efficient way of testing the presence of the yeast but it takes several days for getting a definitive result so cannot be done on critically ill patients.

CrAg or CRAG test is also a very efficient way of testing for the presence of the pathogen. CSF CRAG is produced in the subarachnoid space by the invading yeast species. Positive CrAg is considered a 95% confirmed result if the infective agent is present.

gladiator answered 1 year ago

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