Case study A patient has been admitted to your pediatric intensive care unit. He
ID: 141467 • Letter: C
Question
Case study
A patient has been admitted to your pediatric intensive care unit. He is a twelve-month-old male who was transferred to your institution with a six-day history of respiratory infection. Furthermore, the patient has not been moving or eating for the past day. Shortly before admission the parents noticed that the child was having difficulty breathing. On admission the patient had a fever and enlarged lymph nodes, but his lower respiratory tract was normal and appeared to be uninfected. The patient also had an inflamed pharynx, which was producing yellow pus. There was also a thick layer of yellowish-green material over the pharynx, which bled when the patient’s throat was swabbed. The swab was used to culture and Gram-stain the pus, which had a large amount of purple bacilli. His diet consisted primarily of breast milk, and occasionally honey. The patient’s medical history revealed that he had received no immunizations. The father had recently returned from Western Uganda where he had been performing anthropological research on local populations in the area. Both parents had visited various parts of Africa over the previous decade.
1) What disease does the child have, and how did you determine this? State the proper scientific name of the causative organism. What domain and kingdom does the responsible pathogen belong to? If it doesn’t belong to a domain or kingdom, try to classify it as best you can. 2) What body system did the pathogen target, and how did the child contract the disease? What mechanism does the microbe you identified use to cause the disease? What route of entry did it use? 3) How would you treat this disease? Explain what each treatment involves in detail, and how it will help. 4) Is the disease communicable?
Explanation / Answer
1) The child is suffering from diphtheria. This can be determined by the presence of fever, enlarged lymph nodes, inflammed pharynx and yellowish pus. The organism isolated when subjected to gram staining procedure stains purple bacilli. Further, the child is not immunised and his parents had a travel history to Africa. All of the above mentioned points lead to the diagnosis of the disease as diphtheria.
The causative organism is Corynebacterium diphtheriae. It belongs to the kingdom of bacteria under the phylum actinobacteria. The order is actinomycetales, suborder is corynebacterineae, family is corynebacteriaceae, genus is corynebacterium and species diphtheriae.
2) The pathogen has targeted the upper respiratory tract. The child contracted the disease from his parents as he is not immunised against the disease. The pathogen secretes toxin which is responsible for all the above symptoms. The disease spreads through droplet infection, through respiratory route.
3) Treatment includes antibiotics such as penicillin and erythromycin. Diphtheria antitoxin can also be used. There is an effective diphtheria toxoid vaccine.
4) Diphtheria is communicable disease.