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III . A 27-year old white female presented herself at her local physician on Aug

ID: 245108 • Letter: I

Question

III. A 27-year old white female presented herself at her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender abdomen and complained of headache, stiff neck and backache with diarrhea. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate. The patient gave the following history: She is a graduate student in the wildlife program at the University in her town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of flies in the area. She felt sick the last day there after eating some canned food, as there was no cooler there. You had no time for culturing, as you need to take action fast.

What type of disease she could have based on the symptoms and why? You are not required to name a specific disease but a general type of disease. Naming a disease means you have answered the question wrong.

What features are not critical to your diagnosis from the case & why?

What further steps should be taken to precisely identify the case & why? What microbes you will not consider and why [name 4].

What steps would you take to ensure that the patient is stable till diagnosis is confirmed; explain why would you do this?(microbiology)

Explanation / Answer

The above mention sign and symptoms show the patient was infected with LYME DISEASE

many of people infected with this disease by prolonged time spending in grassy and heavy woodened area where ticks carring the disease thrive

early sign of this disease include rashes and flu like symptoms

later sign include erythema migrane,joint pain and neurological problems

antibiotic therapy used for treatment

monitor the patient for -

chronic joint inflammation specially knee

neurological symtoms such as facial palsy

cardiac problem

impaired memory