Question #2 pls ! CASE The patient was a 46-year-old male who presented with com
ID: 214832 • Letter: Q
Question
Question #2 pls ! CASE The patient was a 46-year-old male who presented with com plaints of fever. Ten days previously the patient had returned from a holiday trip during which he visited his family in Guatemala. He was both in urban areas and at the Caribbearn coast. He received many mosquito bites and did not take malaria prophylaxis. He had one episode of diarrhea during his visit, but that resolved within 1 day. One week prior to presentation he began to develop malaise, headache, and fevers with some sweating and chills. Over the 3 days prior to presentation he had fevers throughout the day to 39.0°C with drenching sweats. He also complained of intermittent headaches. He did not complain of stiff neck, diarrhea, or abdom inal pain. His urine appeared somewhat darker than normal to him. He had nor- mal oral intake. On physical examination his temperature was 38.5 C, his blood pressure wás 133/85 mm Hg, and his pulse was 145 beats/min. He had no nail bed hemor- rhages and no petechial lesions. The remainder of his physical examination was within normal limits. He had a white blood count of 13,500 cells/ul with 10,000 neutrophils/1.A peripheral blood smear is shown in Fig. 55.1. Figure 55.2 shows a triple sugar iron (TSI) slant of the organism that was recovered from the patients blood. 1. Given his travel history, name three organisms that are likely to have been responsible for his fever. How do his peripheral blood smear and the TSI slant in Fig. 55.2 help to narrow the list? What about his phys- ical examination rules out one of the pathogens? 2. How did this patient likely become infected with this organism? 3. This infection typically occurs in individuals who return from foreign countries or are immigrants from those countries. What countries are the most common source for this infection for patients in the United States?
Explanation / Answer
Answer 2.well, the patient looks like infected with malaria parasites.From the peripheral blood smear figure, it is evident that it is Plasmodium falciparum and the stage is trophozoite.Although malaria is not common in areas having altitude less than 1500meters and Guatemala and the Carribean,the risk is low but present.The patient might have got bitten by female Anopheles mosquitos in either of the places and got infected with malaria.However, since malaria infection is sensitive to chloroquinone, the patient is treatable with the drug and can be cured.