An 18-year old woman has come into your office presenting with a red, ring-shaped lesion that resembles a "bull's eye" on her thigh, fatigue, fever and chills, and myalgia. She tells you that she first noticed the rash and onset of symptoms about 1 week after returning home from visiting her grandparents in Connecticut. She goes on to tell you that she had such a great time visitng her grandparents and that she loves that they live deep off in the woods and are "so close to wilderness". She tells you that her and her grandparents really enjoy being outdoors. You take a blood sample and gram stain it. Upon examination under the microscope you find gram- spirochetes. What is the diagnosis and what is the most likely pathogen involved?
C. Early (first) stage of Lyme disease; Borrelia burgdorferi
A man brings his 6-year old son into your office because he has concerns with his son's high fever and chills for the past 3 days and his fever tends to reoccur in periodic cycles with decreasing severity. He goes on to tell you that his son's school just recently had a lice break-out and he's not sure if this is the cause for his son's illness. You take a sample of the boy's blood and are able to identify spirochetes with a Giemsa stain under a microscope. What is the diagnosis and what pathogen is most likely involved?
B. Relapsing fever; Borrelia recurrentis
What complication can be seen when treating relapsing fever?
A 35-year old man comes into your office presenting with conjunctival hemorrhage and jaundice. He does not have a history of elicit IV drug use and up until a bout a week ago has been as "healthy as a horse". He tells you that a few weeks ago he and his family went to a BBQ/pool party at a neighbor's house and took a few dips in the pool. He seemed rather annoyed when he tells you that the neighbor's dog would not stay out of the pool. "I hate dogs", he says, "I don't know why they didn't just lock him up." You take a blood sample and exam it using darkfield microscopy, spirochetes are visible. What is the diagnosis and what pathogen is most likely involved?
C. Leptospirosis; Leptospira spp.
A 9-year old boy is brought into your office because of an infected dog bite. His mother tells you that the cellulitis developed about 2 days after her son was bit. You take a sample of the boy's blood and perform a routine blood cultue on blood and chocolate agar. Small gram-, oxidase+, bacilli grow. What pathogen is most likely involved?
A. Pasteurella multocida
True or false. Rickettsiae spp. are obligate intracellular organisms and can grow in the cytoplasm and the nucleus of its host.
A 37-year old HIV patient comes into your office presenting with weight loss, nausea and fever, and skin lesions that resemble Kaposi's sarcoma. She says that people refer to her as "the cat lady" because she owns 5 cats and 2 kittens. She tells you that one night she was preparing a bowl of warm milk for her "babies" and one of the kittens got so excited that it accidently scratched the woman on her hand as she was placing the bowl on the kitchen floor. You have an idea of what the diagnosis is, but you want to confirm. You aspirate pus from her enlarged lymph node, gram stain it and exam it under a microscope. Small gram-, slightly curved rods are visible. The diagnosis is now confirmed. What pathogen is most likely involved?
B. Bartonella henselae
A patient comes into your office complaining of fever, chills, headache and myalgia following a tick bite, but does not have a rash. You take a blood sample and exam it under a microscope. You find gram- coccobacilli organisms. These organisms can infect monocytes or granulocytes and are obligate intracellular pathogens. What are they?
C. Ehrlichia chaffeensis
ZOONOTIC AND VECTOR-BORNE INFECTIONS - DR. JACKSON