e sorting of goat hair was the origin of most human infections historically. The disease has a prolonged latent period of up to two months or more. The initial symptoms are non-specific, the second stage having more dramatic symptoms and a rapidly worsening course. Pulmonary disease is rare, the spores usually being cleared in the lower airways. The disease, once spread to the lungs, is fatal within three days unless treated immediately. B. anthracis is resistant to sulfonamides and extended spectrum cephalosporins. It is susceptible to penicillin but may be resistant to penicillin and doxycyclin.
Patient Profile: 78-year-old male with a history of hypertension.
Admitted to hospital with severe headache of 4 hours duration. After placement of left ventricular-atrial shunt, fever developed one week later.
Chief Compliant: headache of 4 hours duration
Tests: -MRI of head showed subarachnoid hemorrhage and hydrocephalus.
-blood cultures and cultures from shunt showed Corynebacterium jeikeium.
Diagnosis: Initial: subarachnoid hemorrhage, hydrocephalus
Remarks: C. Jeikeium is an opportunistic pathogen in immunocompromised patients, particularly those with hematological disorders. A mucocutaneous portal of entry is a predisposing condition and this patient no doubt got the infection through the operation site because the bacterium colonizes the skin of 40 percent of hospitalized patients. The bacterium is typically resistant to antibiotics, so antibiotic therapy in hospital increases the chances of infection, and the only antibiotic which can be used is vancomycin.
Patient profile: 57-year-old male hospitalized with a 2-day history of severe, watery diarrhea. Illness began 1 day after returning from Ecuador. Patient made an uneventful recovery after fluid and electrolyte replacement.
Chief Compliant: severe, watery diarrhea
Signs/symptoms: severe watery diarrhea, dehydration, electrolyte imbalance ...