CLINICAL CASE 10 Clinical Case 10/1 In late June, a male infant, of normal weigh
ID: 3480856 • Letter: C
Question
CLINICAL CASE 10 Clinical Case 10/1 In late June, a male infant, of normal weight, was born to a primiparous mother after a full-term, uncomplicated pregnancy. The mother had received prenatal care and tests for STDs were reported as negative whereas the father had been diagnosed as having STD 9 days before the infant's birth. The mother was admitted to the obstetric ward in active labour, with spontaneous rupture of membranes and a copious green vaginal discharge. Hours later, a normal infant was delivered vaginally. The infant's eyes were treated with erythromycin ophthalmic ointment about 5 minutes after delivery. Approximately 24 hours after birth, the results of the cultures obtained from the mother the day before delivery were reported as positive for a gram-negative diplococci, oxidase-positive organism, and both the mother and the child were treated with penicillin. At 2 days of age, the infant developed a copious yellowish discharge from both eyes, along with ocular swelling and redness. The same microbe was isolated. The infant was treated with aqueous penicillin, 50,000 units/kg intravenously (IV), for 7 days. In addition, his eyes were washed with saline every 30 minutes to 1 hour, and tetracycline eye ointment was instilled after each saline irrigation. The infant's eyes gradually improved over the next 2-3 days Topical therapy was maintained for 5 days. Examination by an ophthalmologist revealed no corneal damage. 1. What is the microorganism described here as gram negative, oxidase- positive? 2. What is the role of this microorganism in causing STD? In males? In females? 3. How the infant got infected? 4. Is this infection serious? What may happen if is neglected? 5. Why both of them (mother and the child) were treated with penicillin?Explanation / Answer
1) The bacteria described here is Neisseria gonorrhoeae. It is a gram negative diplococci bacteria responsible for sexually transmitted disease.
2) This bacteria can cause white, yellow or green discharge around the tip of the penis. It leads to burning sensation while urinating and also itching around the penis. It can also lead to swelling and pain in testicles.
In women it can develop into pelvic inflammatory disease..
3) . The infant got infected because both the parents were found to be infected with this bacteria. Thus, during the pregnancy it was transmitted from the mother to the baby.
4) If this is left untreated it can cause serious health issues both in men and women. It can also spread to blood or joints if left untreated for a longer period.
In women it can cause pelvic inflammatory disease which is a very painful disease and can cause infertility or even death. In men also it can be very painful and leads to sterility.
5) The mother and the infant is treated with penicillin because both of them were found to be positive for gram negative diplococci. This antibiotic penicillin is used for the treatment of STD.