Question

A 13-year old girl is brought to hospital by her mother. She is reported to have a sudden onset of fever (103⁰ F), lightheadedness, nausea, vomiting and watery diarrhea. Physical examination reveals a desquamating rash of her palms and soles. She has no sick contact and there is no evidence of food poisoning. Upon questioning the patient says she started menstruating (menarche) a little over a month ago and she currently just finished her periods.

1. What is the microbial agent? Describe the morphology (shape, arrangement, gram reaction) and cultural properties (O2 requirement, biochemical requirements, motility, etc.) for this microbe.
2. Explain the spread or the occurrence for this infection (cause and transmission) and pathogenicity (virulent factors) of this agent relevant to this case study.
3. Describe the diagnoses (source of specimen, lab tests, and results that confirm your microbe) and treatment (name of Rx, what it targets, why/how does it work against this microbe) also include the general management of this patient.

Answer 1

Microbial agent:- Staphylococcus aureus.

Morphology:-facultative anaerobic, gram positive coccus which appears as grape like clusters under the microscope.

Cultural character:-golden yellow colonies on nutrient agar, Hemolysis on blood agar, anaerobic, non motile organism.

Cause and transmission:- Toxic Shock Syndrome is caused more commonly in Menstruating woman due to too much use of tampons. The bacteria releases toxins which are responsible for the clinical characteristics. It leads to multisystem spread of infection via blood stream.

Pathogenicity:-Via Toxic Shock Syndrome Toxin-1, infection is spread via cut, then it enters the blood stream and spread to the whole body.

Diagnosis:-Complete blood count, serology testing usually reveals toxins in the body.

Treatmemt:-antibiotics such as vancomycin. It inhibits the cell wall synthesis of the bacteria.

General management:--giving iv fluids for diarrhea, iv antibiotics, antipyretics if necessary.