Question

A missionary couple, living in West Africa bought their 4-year old son to the Emergency room as he had fever and a pinkish rash has been developing on his hands and feet at first then it spread to both arms and legs. There are no other symptoms that the child feeling very fatigued. 1. This disease is most likely caused by what bacteria? Name the disease. 2. How would epidemiology assist you in finding the sources of this illness? 3. The boy had all of his vaccines so why does he have such a disease? 4. What course of treatment would you order and why? What type of antibiotic would you use and why? 5. What are the virulence factors for the causative agent? Explain the mode of action of these factors

Answer 1

1. The disease is most likely caused by Staphylococcus bacteria
2. The disease appears to be Cellulitis.
2. The disease is found in the West African region and often described as travellers disease. The boy has no other symptoms except skin rashes and fatigue.
3. This is a skin infection and vaccination does not prevent the skin infections which do not elicit an antibody-mediated immune response. hence the vaccination would not prevent such infections.
4. The best course of treatment would be antibiotics. If the rashes are severe, antibiotic ointments can be prescribed. The patient can be admitted and intravenous antibiotics can be given.
These bacteria are notoriously resistant to antibiotics. The common antibiotics for staph infections include cephalosporins, nafcillin, sulfa drugs or vancomycin.
5. Staph infections usually accompanied by the release of toxins. Several toxins secreted by staph include shock syndrome toxin, PVL, ETA and ETB which cause skin infections. These toxins reduce the level of WBCs in the blood. the reduction in WBC renders the immune system weak and the host is unable to defend against the infection. The toxins can cause excessive release of cytokines and chemokines which can lead to multiple organ failures.