Patient Profiles

Signs/Symptoms: temperature 40oC, blood pressure 94/52 mm Hg, respiration 18 breaths/min, chills, nausea and vomiting, production of increasing volumes of tenacious yellowish sputum of 3 days duration

Tests: chest xray revealed extensive infiltrates in the left lower lung involving both the lower lobe and the lingula

multiple blood cultures and culture of sputum yielded Streptococcus pneumoniae

The isolate was susceptible to cefazolin, vancomycin and erythromycin but resistant to penicillin

Diagnosis: Streptococcus pneumoniae - pneumonia

Treatment: Cefazolin, vancomycin or erythromycin

Remarks: S. Pneumoniae is spread from colonization of the nasopharynx. It is found in young children, and in individuals who have trouble clearing bacteria from the respiratory tract - in this case the patient had COPD and therefore was unable to clear the bacteria from his respiratory tract and thus more susceptible to infection of the lungs with the bacteria.

Patient Profile: 56-year-old female postal worker sought medical help for fever, diarrhea and vomiting. She was treated symptomatically and not admitted to hospital. She returned five days later with chills, dry cough, pleuritis and chest pain. She was admitted to hospital where respiratory status and pleural effusions worsened.

Chief Complaint: Initial visit: fever

. . .
s associated with infections above the waist, HSV-2 with infections below the waist, so this is most likely an HSV-1 infection. Infection is by close contact.. The infected child will be a lifelong source of contagion with the virus. Acyclovir is acted on by the virus and incorporated into viral DNA and prevent its elongation. Acyclovir is relatively non-toxic to the patient. Patient Profile: 11-year-old boy treated at the hospital for bruises from a fall and released. Refused water and medication next day, and that night began to act up and hallucinate. He was salivating and had difficulty breathing. Two days later he had a fever and two episodes of cardiac arrest. The patient's condition continued to deteriorate and he died 11 days later. The parents reported the boy had been bitten on the finger by a dog 6 months previously on a trip to India. Chief Complaint: cardiac arrest Signs/symptoms: temperature 40.8oC, cardiac arrest, hallucinations, unusual behavior, Tests: -Cat scan was negatived -CSF analysis was negative -skin biopsy from nape of neck negative for viral antigen on day 3 but positive for rabies on day 7 Treatment: None given - immunization with vaccine in combination with one dose of human rabi
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Approximate Word count = 3231
Approximate Pages = 13 (250 words per page)

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