Question

A 17 year-old man walked into a local clinic in Puerto Viejo, Costa Rica, complaining of fever (102.7°), headaches, decreased energy and appetite, and a rash that was most pronounced after bathing. The patient’s right eye was swollen shut, and he reported it was both painful and itchy. No eye discharge was detected. Bloodwork results found the patient to have a white blood cell count of 6.1 x 10³ cells/µL, and a platelet count of 3.8 x 10⁹/L. Blood, cerebral spinal fluid, intestinal, and stool samples were collected and sent to the hospital laboratory for analysis. Urinalysis failed to demonstrate any abnormalities and creatinine levels were found to be 0.6 mg/dL.

The organisms to consider for your case study are:

• Cryptosporidium parvum
• Entamoeba histolytica
• Plasmodium spp.
• Toxoplasma gondi
• Trichmonas vaginalis
• Trypanosoma gambiense

1. What is the organism you identified?
2. What evidence led you to this conclusion?
3. What would you expect to see under the microscope in samples collected from: blood, cerebral spinal fluid, intestines, and stool?
4. What additional samples would you request (if any) and why? What is the suggested treatment regime?

(I suspect its Chagas disease but I am struggling with the third and fourth question.)

Answer 1

Answer;

1. What is the organism you identified?

The above case study mentioned disease is Chagas diseases

It is also called American tryponosomiasis

It's a tropical parasitic disease caused by protozoan

The organism caused by Chagas disease is Trypnosoma gambiense.

2.What evidence led you to this conclusion?

Evidence suggest the case study belongs to chagas disease are the patient right eye become swollen shut,no discharge ,painful and itchy this is the typical sign of chegas disease these sign called as Romana's sign.

The patient also had typical signs like headache,loss of appetite and energy level these signs strongly suggest that patient had Chagas disease.

3.What would you expect to see under the microscope in samples collected from: blood, cerebral spinal fluid, intestines, and stool?What additional samples would you request (if any) and why?

The blood sampling excepted to see under the micro organism

The blood smear are used to detect the organism in acute phase because the organism are more evident during this stage

By using Both thick and thin smears can be made and it helps to visualise the micro organism easily under microscope

The additional sample is CSF,The CSF may contain the present of organism due to occasional development of meningoencephalitis as a complication of Chagas disease,so CSF analysis one of best sample to detect the presence neurological infections

4.What is the suggested treatment regiment?

Suggested treatment regiment

Antiparasitic treatment; The antiparasitic agents like azole or nitro dderivatives such as benzimidazole and nifrutimox are used to treat chagas disease.

Managing the clinical manifestations by

Pacemaker

medicationsfor irregular heart beats

Antiarrhythmic drugs like ameodaron can be administer

Heart transplantation in end stage can be recommended

Surgery for megaintestine

Immnuno suppressive therapy eg; cyclosporine low dosage can be administer

Direct stem cell transplantation for heart by using bone marrow cell transplantation.

Prevention

No vaccine against Chagas disease

Decreasing the number of insect spreading by improving sanitation.

Use spray and paints contain insecticides to kill the organism

Mosquito net is recommended

Development and implementation of blood bank screening test.