A 34-year-old female reports to the emergency room in Boston, Massachusetts complaining of severe watery diarrhea,...

A 34-year-old female reports to the emergency room in Boston, Massachusetts complaining of severe watery diarrhea, abdominal cramps and nausea. She had not eaten anything since the previous evening, when she and some friends met for happy hour at the local seafood restaurant. The emergency room physician noted that several other patients who had eaten at that restaurant had also come in to the hospital in the last few hours, complaining of similar symptoms. MacConkey plates showed a non-fermenting organism, and a gram stain showed a curved, gram-negative organism.

What is the most likely organism causing this woman’s infection?

What laboratory testing should be performed to confirm this diagnosis, and what are the expected results? Include any special media as well as routine biochemical testing.

What is the best treatment for this patient? What is the typical pattern of susceptibility for this organism?

What are the public health concerns related to this case – what will the state’s health department do to investigate this situation?

Expert Solution

Hi Answer:

Q. What is the most likely organism causing this woman’s infection?

Answer: As per the symptoms of infection and the morphological characterization given in the question the causative agent of this infection is Salmonella gastroenteritis. Salmonella infection is usually caused by eating raw or undercooked meat products. Its incubation period varies from 2 hr to 2 days.

Q. What laboratory testing should be performed to confirm this diagnosis, and what are the expected results? Include any special media as well as routine biochemical testing.

Answer: Stool samples are the most preferred sample to test the presence of salmonella infection. Clinical samples are grown on selective media such as Xylose-Lysine-Desoxycholate (XLD) agar and incubated at 37oC for 18-24 hours. Whereas the stool samples are grown in selective enrichment broth, such as selenite cysteine broth and incubated at 37oC for 18-24 hours, before plating out onto selective agars. These traditional methods took 3-5 days for identification so other rapid detection methods are invented. The salmonella detection kits are available in the market which is based on several fast detection techniques such as EIA- and ELISA-based assays incorporating fluorescent or colorimetric detection, and molecular techniques such as DNA hybridization and PCR-based assays, many of which now include real-time detection. The major biochemical test for salmonella is fermentation of glucose, negative urease reaction, lysine decarboxylase, negative indole test, H2S production, and fermentation of dulcitol. Whereas in case of rapid detection EIA and ELISA have been developed for salmonella.

Q. What is the best treatment for this patient? What is the typical pattern of susceptibility for this organism?

Answer: the best treatment for the Salmonella is to replace the body fluids using electrolyte solution such as diaoralyte which is the mixture of salt and sugar in water. It is seen that the salmonella found in the poultry products is resistant to several antibiotics and it is the major cause of salmonella infection in humans.

Q. What are the public health concerns related to this case – what will the state’s health department do to investigate this situation?

Answer: Salmonella gastroenteritis infection took place by eating contaminated food and it causes a type of food poisoning in the individuals who took contaminated food. First of all the health department must pose check on the source means the restaurant from where this infection spread into the society and guide the individual that how to eradicate the infection from the restaurant and second guide the suffering individual to protect them from further infection and encourage then to maintain personal hygiene.

gladiator answered 1 year ago

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