Showing posts with label MMIC. Show all posts
Showing posts with label MMIC. Show all posts

Sunday, December 2, 2007

Group Post: MMIC dPBL 1

List of possible organisms for each case
Diagnosis Possible bacteria species Morphology & Microscopy
Case 1 Urinary Tract Infection (UTI)
Staphylococcus aureus

Staphylococcus saprophyticus

Enterococcus faecalis

Gram Positive, Spherical-shaped, immobile and form grape-like clusters

Gram Positive, Cocci-shaped occur singly and in pairs, short chains, and grape-like clusters

Gram Positive, Cocci-shaped in pairs and chains
Case 2 Enterocolitis
Campylobacter jejuni

Shigella species

Salmonella species

Escherichia coli (entero-pathogenic; EPEC)

Clostridium perfringens

Clostridium difficile

Vibrio Cholerae

Vibro parahemolyticus

Bacillus cereus

Yersinia enterocolitica

Staphylococci aureus

Gram-negative rods

Gram-negative rods

Gram-negative rods

Gram-negative rods

Gram-positive rods

Gram-positive rods

Gram-negative rods

Gram-negative rods

Gram-positive rods

Gram-negative rods

Gram-positive cocci
Case 3 Urinary Tract Infection (UTI)
E. coli

Klebsiella sp (Klebsiella pneumuniae, Klebsiella oxytoca)

Enterobacter (Enterobacter aerogenes)

Serratia

Proteus mirabilis

Morganella morganii

Pseudomona aeruginosa

Staphylococcus aureus

Staphylococcus saprophyticus

Enterococcus sp.

Gram negative bacilli

Gram negative bacilli

Gram negative bacilli

Gram negative bacilli

Gram negative bacilli

Gram negative bacilli

Gram negative bacilli

Gram positive cocci

Gram positive cocci

Gram positive cocci
Case 4 Bronchitis
Strep. Pneumoniae

Klebsiella-Enterobacter-Serratia (Klebsiella sp.)

Bordetella pertussis

Gram positive, diplococci, lancet-shaped

Gram negative rods

Gram negative, coccibacilli
Case 5 Wound Infection
Beta Haemolytic Streptococci (Streptococcus pyogenes)

Enterococci (Enterococcus faecalis)

Staphylococci (Staphylococcus aureus/MRSA)

Clostridium

Pseudomonas aeruginosa

Enterobacter species

Escherichia coli

Klebsiella species

Proteus species

Bacteroides

Gram-positive facultative anaerobes cocci

Gram-positive facultative anaerobes cocci

Gram-positive facultative anaerobes cocci

Gram-positive anaerobe rod

Gram-negative aerobic rods

Gram-negative facultative rods

Gram-negative facultative rods

Gram-negative facultative rods

Gram-negative facultative rods

Gram negative Anaerobes rods
Case 6 Urinary Tract Infection (UTI)
Gardnerella vaginalis

Chlamydia trachomatis

Neisseria gonorrhoeae

Ureaplasma urealyticum

Staphylococcus saprophyticus

Enterobacteriaceae (E. coli, serratia, klebsiella, enterobacter, citrobacter)

Enterococci

Gram-negative rod with a gram-positive cell wall

Gram-negative bacteria, coccoid or rod-shaped

Gram negative cocci

Gram-negative bacteria

Gram positive, globular shaped, colonies resemble grape-like clusters

Gram-negative, rod-shaped

Gram-positive cocci which often occur in pairs (diplococci)
Authors: Lizzie, Kent & Ye Tun, Joan, Charmiane, Ai Tee and Adrian (according to case no.)


Brief description of diagnosis:


1. Urinary Tract Infection (UTI)


A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. The urinary tract is made up of the kidneys, ureters, bladder, and urethra, and each plays a role in removing liquid waste from the body. Although urine contains a variety of fluids, salts, and waste products, it usually does not have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they cause a UTI.

Cystitis: bladder infection.

Pyelonephritis: kidney infection is much more serious.

Urethritis: urethra infection.

Each type of UTI may result in more specific signs and symptoms, depending on which part of your urinary tract is infected. The symptoms shown in acute pylonephritis are closest to what is given in the case study, whereby it is an infection of your kidneys may occur after spreading from an infection in your bladder. Kidney infection can cause upper back and flank pain, high fever, shaking chills, and nausea or vomiting.

Pyelonephritis is an inflammation of the kidney and upper urinary tract that usually results from noncontagious bacterial infection of the bladder (cystitis). In acute pylonephritis, bacteria begin colonising the tubules and connective tissue of the kidney itself. Small abscesses and streaks of pus begin to appear in the renal cortex and medulla respectively. Pyelonephritis most often occurs as a result of urinary tract infection, particularly in the presence of occasional or persistent backflow of urine from the bladder into the ureters or kidney pelvis (vesicoureteric reflux).

Urinary catheterization is the insertion of a catheter into a patient's bladder through the urethra, to drain urine from the bladder into an attached bag or container. Indwelling catheters should be restricted to patients whose incontinence is caused by urinary tract obstruction that can not be treated, and for which alternative therapy is not feasible. However, the catheter may introduce bacteria into the urethra and bladder, resulting in urinary tract
infection. The risk for developing a UTI increases when long-term catheterization is required.

Bacteria causing UTI may be isolated from the vaginal discharge. UTI can also result from sexual intercourse where bacteria from the vaginal area is transferred to the urethra and bladder.

Authors: Lizzie, Joan and Adrian


2. Enterocolitis


Enterocollitis is the inflammation of the small intestine and colon. Disease-causing bacteria usually invade the small intestines and colon and cause inflammation (blood or pus in the stool, fever) and abdominal pain and diarrhea. Campylobacter jejuni is the most common bacterium that causes acute enterocolitis in the U.S. Other bacteria that cause enterocolitis include Shigella, Salmonella and EPEC (E. Coli Enteropathogenic). These bacteria usually are acquired by drinking contaminated water or eating contaminated foods such as vegetables, poultry, and dairy products.

Enterocolitis caused by the bacterium Clostridium difficile is unusual because it often is caused by antibiotic treatment. It is also the most common nosocomial infection (infection acquired while in the hospital) to cause diarrhea.

E. coli O157:H7 produces a toxin that causes hemorrhagic enterocolitis (enterocolitis with bleeding). There was a famous outbreak of hemorrhagic enterocolitis in the U. S. traced to contaminated ground beef in hamburgers (hence it is also called hamburger colitis).

Bacterial overgrowth of the small intestine.

Because of small intestinal problems, normal colonic bacteria may spread from the colon and into the small intestine. When they do, they are in a position to digest food that the small intestine has not had time to digest and absorb. The mechanism that leads to the development of diarrhea in bacterial overgrowth is not known.

Authors: Kent and Ye Tun

3. Bronchitis


Bronchitis is an inflammation of the bronchi of the lungs. There are two main types of bronchitis: acute and chronic bronchitis.

Acute bronchitis can be caused by viruses such as influenza A and B, parainfluenza virus, respiratory syncytical virus, coronavirus, adenovirus, and rhinovirus. Bacterias are also able to cause acute bronchitis. Air pollutants such as cigarette smoke, dusts, or fumes of chemicals are also able to cause acute bronchitis.

The symptoms of acute bronchitis include:

* Sore throat

* Chest congestion

* Sinus fullness

* Breathlessness

* Wheezing

* Slight fever and chills

* Overall malaise

* Cough

Chronic bronchitis is where by the signs and symptoms become prolonged, and is defined clinically as a
persistent cough that produces sputum (phlegm) and mucus, for at least three months in two consecutive years. Chronic bronchitis is part of chronic obstructive pulmonary disease (COPD).

Author: Charmaine

4. Surgical Site Infection (SSI)


There are different levels of SSI:

• Superficial incisional, affecting the skin and subcutaneous tissue.

• Deep incisional, affecting the facial and muscle layers.

• Organ or space infection affecting any part of the anatomy opened or manipulated during the operation.

Symptoms: Pain, fever, inflammation, swelling and pus formation



Causes of infection:

-Microbes contamination (most commonly by S. aureus, S. pyogenes or P. aeruginosa

-Migration of patients’ own bacterial normal flora

-The materials or equipment used in the operational procedures (for e.g.: poor surgical techniques)

Author: Ai Tee

Saturday, May 5, 2007

MMIC: Case Study 1

Description of Potential Diseases:

Cat-scratch Disease (A,B)
Transmission vehicle: Most commonly by kittens, also spread by cats & dogs, with fleas as intermediate hosts
Bacteria: Bartonella henselae
Causes: Bites and scratches by infected vehicle, contact with infected vehicle’s saliva on open lesions
Signs and symptoms: Bump or blister at site of injury, swelling of lymph nodes near sit of injury, fatigue, low fever, headache, malaise & enlarged spleen (less common)
Epidemiology: Found world wide (1, 9)

Lyme Disease (A,B)
Transmission vehicle: Ticks on cats and dogs.
Bacteria: Borrelia burgdorferi
Causes: Bite of infected tick.
Signs and symptoms: Fever, skin rash, joint inflammation, and flu-like symptoms
Epidemiology: USA (6, 10)

Rat-bite Fever (A,B)
Transmission vehicle: Fluids in the mouth or nose or urine of an infected rodent.
Bacteria: Streptobacillus moniliformis & Spirillum minus
Causes: Bite of an infected rodent or contact with its secretions
Signs and symptoms: Fever, rash (red or purple plaques), headache and muscle ache.
Epidemiology: Japan, Australia, Africa, North and South America, and Europe. (5, 12)

Rocky Mountain Spotted Fever (A,B)
Transmission vehicle: Ticks on cats and dogs.
Bacteria: Rickettsia rickettsii
Causes: Bite of infected tick
Signs and symptoms: Fever, rash, muscle pain, nausea, vomiting and diarrhea.
Epidemiology: Asia and USA (3, 9)

Toxoplasmosis (A, B)
Transmission vehicle: Most commonly in cats, and also by birds and other animals
Bacteria: Toxoplasma gondii
Causes: Ingestion of contaminated soil, careless handling of cat litter, ingestion of raw or undercooked meat
Signs and symptoms: swollen lymph glands, muscle aches, reduced/blurred vision, fever & headache
Epidemiology: More common in North America (2, 13)

Typhoid Disease (A,B)
Transmission vehicle: Ticks carrying the bacteria previously in contact with chronic stool carrier.
Bacteria: Salmonella typhi & Salmonella paratyphi
Causes: Ingestion of contaminated food or water, sewage & shellfish
Signs and symptoms: Severe headache, fever, loss of appetite, fatigue, constipation, diarrhea, abdominal tenderness, rose spots on lower chest and abdomen, high fever & bloody stools
Epidemiology: Found worldwide, especially in Asia, Africa, Latin America, the Caribbean, and Oceania (4, 7)

Typhus (A,B)
Transmission vehicle: Ticks and fleas on rats and cats.
Bacteria: Rickettsia typhi (murine or endemic) & Rickettsia prowazekii (epidemic)
Causes: Bite of infected flea or tick.
Signs and symptoms: Extremely high fever, dull red rash that begins on middle of the body and spreads, nausea, vomiting and headache
Epidemiology: USA (11, 14)

-------------------------------------------------------
Preliminary diagnosis:

The symptoms of these disease includes rashes, high fever, and general weakness (fatigue) (3, 4, 5, 6, 7, 8, 10, 11, 12, 14):
1. Lyme Disease
2. Rat-bite Fever
3. Rocky Mountain Spotted Fever
4. Typhoid Fever
5. Typhus

Cat Scratch Disease is rejected due to the following reasons:
- The symptoms of Cat Scratch Disease does not include rash, which is one of the prominent features of this situation
- The fever caused by Cat Scratch Disease is low, however, in this situation, the patient's fever is high. (1, 9)

Toxoplasmosis is rejected due to the following reason:
- The symptoms of Toxoplasmosis does not include both general weakness (fatigue) and rash, which are symptoms found on the patient. (2, 13)

-------------------------------------------------------

References:

1. American Uveitis Society. (2003). Cat-Scratch Disease. Retrieved May 5, 2007, from http://www.uveitissociety.org/pages/index.html > Search> Search: Cat scratch disease > Cat-Scratch Disease

2. Centers for Disease Control and Prevention. (2004). Toxoplasmosis. Retrieved April 25, 2007, from http://www.cdc.gov/index.htm > Search: Toxoplasmosis > Toxoplasmosis: Index | CDC Parasitic Diseases > Fact Sheet: Toxoplasmosis

3. Chinese University of Hong Kong. (2006). Rickettsia. Retrieved May 6, 2007, from www.aic.cuhk.edu.hk > Search Rickettsia > Rickettsia

4. eMedicine. (2006). Typhoid Fever. Retrieved May 9, 2007, from http://www.emedicine.com/ > eMedicine Specialties > Medicine, Ob/Gyn, Psychiatry, and Surgery > Infectious Diseases > Typhoid Fever.

5. HeathAtoZ.(2002). Rat-bite Fever. Retrieved 10 May, from, www.healthatoz.com > Search: Rat-bite Fever > Rat-bite Fever

6. Mayoclinic.com. (2006). Lyme Disease. Retrieved May 9, 2007, from www.mayoclinic.com > Search: Lyme Disease > Lyme Disease

7. Medline Plus. (2005). Typhoid Fever. Retrieved May 9, 2007, from www.medlineplus.gov > Medical Encyclopedia > To-Tz > Typhoid Fever

8. Medline Plus. (2005). Rocky Mountain Spotted Fever. Retrieved May 9, 2007, from www.medlineplus.gov > Search: Rocky Mountain Spotted Fever > Rocky Mountain Spotted Fever

9. Medline Plus. (2005). Cat scratch disease. Retrieved April 25, 2007, from http://medlineplus.gov/ > Medical Encyclopedia > C-Cg > Cat scratch disease

10. Medline Plus. (2005). Lyme Disease. Retrieved May 8, 2007, from www.medlineplus.gov > Search: Lyme Disease > Lyme Disease

11. Medline Plus. (2005). Typhus. Retrieved May 7, 2007, from www.medlineplus.gov > Search: Typhus > Typhus

12. Medline Plus. (2005). Rat-bite Fever. Retrieved May 6, 2007, from www.medlineplus.gov > Search: Rat-bite Fever > Rat-bite Fever

13. Medline Plus. (2006). Toxoplasmosis. Retrieved May 5, 2007, from www.medlineplus.gov > Medical Encyclopedia > To-Tz > Toxoplasmosis

14. Wikipedia. (2007). Typhus. Retrieved May 10, 2007, from www.wikipedia.org > Search: Typhus > Typhus


*NOTE*
Direct links under (A,B)

-------------------------------------------------------

Charmaine~
Lizzie~
Adrian~
Joan~
Ye Tun~
Ai Tee~
Kent~

Wednesday, April 25, 2007

MMIC: Case Study 1

A 85-year-old male was found to be staying alone in a one-room flat. It is found that his mattress was soiled with human excreta and urine. The premise is infested with cockroaches, fleas and rats. It is known to the nieghbours that the elderly man has the habit of feeding stray dogs and cats in the neighbourhood.

The elderly man was referred to a nursing home and is presented with high fever, rash and general weakness.

How would you approach this situation in order to provide the final diagonosis of the suspected microorganisms?

-------------------------------------------------------

Potential diseases:

1. Cat Scratch Disease
Medline Plus. (2005). Cat scratch disease. Retrieved April 25, 2007, from http://medlineplus.gov/ > Medical Encyclopedia > C-Cg > Cat scratch disease

Information on the definition, causes, incidence, risk factors, symptoms, signs and tests, treatment of Cat Scratch Disease.

2. Lyme Disease
Mayo Clinic. (2007). Lyme Disease. Retrieved April 25, 2007, from http://www.mayoclinic.com/ > Search: Lyme Disease > Lyme Disease

Information on the introduction, signs & symptoms, causes, risk factors, when to seek medical help, screening and diagnosis, treatment and prevention of Lyme Disease

3. Rat-bite Fever
Medline Plus. (2005). Rat-bite Fever. Retrieved May 7, 2007, from www.medlineplus.gov > Medical Encyclopedia > R > Rat-bite Fever

Information on the definition, causes, incidence, risk factors, symptoms, signs and tests, treatment of rat-bite fever.

4. Rocky Mountain Spotted Fever
Medline Plus. (2005). Rocky Mountain spotted fever. Retrieved April 25, 2007, from http://medlineplus.gov/ > Medical Encyclopedia > R > Rocky Mountain spotted fever

Information on the definition, causes, incidence, risk factors, symptoms, signs and tests, treatment of Rocky Mountain Spotted Fever.

5. Toxoplasmosis
Centers for Disease Control and Prevention. (2004). Toxoplasmosis. Retrieved April 25, 2007, from http://www.cdc.gov/index.htm > Search: Toxoplasmosis > Toxoplasmosis: Index | CDC Parasitic Diseases > Fact Sheet: Toxoplasmosis

Information on the definition, incidences, symptoms, who are the people at risk, what to do if at risk of severe toxoplasmosis or contracting toxoplasmosis, prevention, treatment, will infected cats be able to remain at home and will they always spread the disease to people.

6. Typhoid Fever
Medline Plus. (2005). Typhoid Fever. Retrieved May 9, 2007, from www.medlineplus.gov > Medical Encyclopedia > To-Tz > Typhoid Fever

Information on the definition, causes, incidence, risk factors, symptoms, signs and tests, treatment of typhoid fever.

7. Typhus
Medline Plus. (2005). Typhus. Retrieved May 8, 2007, from www.medlineplus.gov > Medical Encyclopedia > To-Tz > Typhus

Information on the definition, causes, incidence, risk factors, symptoms, signs and tests, treatment of typhus.

-------------------------------------------------------

Charmaine~
Lizzie~
Adrian~
Joan~
Ye Tun~
Ai Tee~
Kent~