Question

. A female patient has been suffering from continuous diarrhea for a week. The stool had a metal like smell. The patient is a nurse at an Assisted living home. She felt sick a week ago and her symptoms resembled that of one of her own patients. Her symptoms have been worsening to the point she is very sick and had to take time off. 1. What disease does she have? Name the causative agent. 2. How did she become infected with this microbe? Explain the pathogenesis of this disease. 3. What is the virulence factor and how would you treat this disease? 4. What would you advise the patient to do in the future to avoid such illness in particular in her line of work.

Answer 1

Please find the answers below:

Answer 1: Based upon the symptoms of the patient, it is unlikely that there is any nutritional deficiency but the symptoms converge to indicate irritable bowel syndrome/inflammatory bowel syndrome (IBS). The condition also converge to indicate possible Crohn's disease if blood is noticed in the stool. The syndrome IBS takes place due to inappropriate immune response of the body against a food material and is generally chronic in nature.

Answer 2: The IBS as well as Crohn's disease do not necessarily require infection with an outside flora/microbe. The gut microflora itself is capable of causing irritation and thus induce inflammatory reactions leading to mis-digestion. Thus, it is very unlikely that the patient herself was infected, its just the improper response of her immune system against any food material which resulted in this syndrome.

As the disease continues, the patient feels feverish, weak and malnutritioned along with feeling of restlessness due to activation of cytokine milieu in the body.

Answer 3: The disease mainly arises due to improper cytokine response and hence inflammation. Thus, non-steroidal anti-inflammatory drugs are helpful to treat this disease.

Answer 4: The patient is highly advised to monitor the nature of food she eats and also required to notice if any particular food item causes allergy to her. Doing this, future cases of IBS/Croh's disease can be avoided.