CASE STUDY PATHOGENIC BACTERIOLOGY 2009 Edmund Yeo Case 52 Team Members: Tania

CASE STUDY PATHOGENIC BACTERIOLOGY 2009 Edmund Yeo Case 52 Team Members: Tania

CASE STUDY PATHOGENIC BACTERIOLOGY 2009 Edmund Yeo Case 52 Team Members: Tania

Varnum, Ann, Host/Producer “The Anne Varnum Show” has reference to this Academic Journal, PHwiki organized this Journal CASE STUDY PATHOGENIC BACTERIOLOGY 2009 Edmund Yeo Case 52 Team Members: Tania Guevara Anthony Obisesan CASE SUMMARY Age: 39 Intravenous Drug User Cellulitis of right arm after several weeks of fevers Used outpatient antibiotics without relief 1-cm vegetation on ventral surface of the aortic valve 2 sets of blood cultures obtained with microorganism present “needle track” marks on upper in addition to lower extremities Cardiac exam showed a grade II/VI systolic murmur Spleen tip was palpable DIAGNOSIS/ ISOLATION/ IDENTIFICATION OF ENTEROCOCCUS Gram stain Growth in CO2 rich environment on a variety of media, including blood agar Able to survive in oxygen rich environments Growth in high salt concentration environment Hydrolization of esculin in the presence of bile Catalase negative

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CLASSIFICATION, GRAM STAIN RESULTS, AND MICROSCOPIC APPEARANCE OF ENTEROCOCCUS Enterococcus species Gram positive cocci in chains Growth in broth containing 6.5% NaCl Hydrolyzed esculin in the presence of bile Catalase negative KEY INFORMATION POINTING TO DIAGNOSIS Intravenous Drug Usage Opens up body to infections from blood infecting organisms because of needle usage in addition to open wounds Antibiotic use without relief 1-cm vegetation on aortic valve Gram stain Growth in high salt concentration broth Esculin hydrolyzation with bile present THE DIAGNOSIS FOR CASE 52 Endocarditis Caused by: Enterococcus species (IVDU) HACEK organisms (IVDU) C in addition to ida albicans (IVDU, immunocompromised) S. aureus (IVDU, contaminated surgery, catheterisation) Pseudomonas species (contaminated water or drugs) S. bovis, Clostridium septicum (breakdown of barrier between gut lumen in addition to blood vessels that drain the bowel) Alpha hemolytic strep species (Dental work)

DISEASES AND PATHOGENESIS OF DISEASE CAUSED BY ENTEROCOCCUS Diseases Endocarditis Bladder infection Prostrate infection Epididymal infection Pathogensis Adherance Platelet aggregation Causes swelling in addition to inflammation due to cell aggregation Tissue factor-dependant fibrin production THERAPY, PREVENTION AND PROGNOSIS OF PATIENT INFECTED WITH ENTEROCOCCUS Therapy Vancomycin should be tested be as long as e administered Vancomycin resistant strains should be treated with Linezolid Prevention Be careful with contaminated hospital equipment Stay away from street drugs, may be contaminated Don’t share needles, might have been used by infected person Prognosis High doses of antibiotic should be administered through IV to maximize the diffusion of the antibiotic into the bloodstream. PRIMARY RESEARCH ARTICLE CONTRIBUTING TO THE UNDERSTANDING OF THE DISEASE CAUSED BY PATHOGEN X Ulrich Sagel, Berit Schulte, Peter Heeg, Stefan Borgmann, 2008, “Vancomycin-Resistant Enterococci Outbreak, Germany, in addition to Calculation of Outbreak Start”, Emerging Infectious Diseases, vol 14: 317-319. They observed incoming in addition to outgoing patients with infections from organism in addition to set up a method to be able to calculate when an outbreak would occur. They found that their model of predicting outbreaks was accurate in addition to could be used to alert hospitals to increase their preparations in admitting infected patients in addition to to double check to make sure they do not have or use contaminated tools. This relates to the case because the patient in this case had been to the hospital many times in addition to was given antibiotics that had no effect on relief. This would show that he might have a resistant strain of some kind of bacterial infection that should have been checked up on.

TAKE HOME MESSAGE Endocarditis involves inflammation of the inner layer of the heart due to vegation of platelets, fibrin, microorganisms, in addition to inflammatory cells. Typical symptoms are chills, cough, fever, fatigue, loss of appetite, weight loss, sweating, muscle aches, in addition to joint pains Pathogen is Enterococcus Diagnostics: Blood test as long as organism presence Gram stain Biochemical tests Therapy is based on the strain of organism, which can have different resistances to different antibiotics Antibiotic sensitivity testing should be done on the organism, then once an effective antibiotic is found, the patient should be treated with it. To prevent infections of this type, avoid contaminated needles or drugs which give the organism easy access to your bloodstream. Also double check hospital equipment as long as cleanliness. This pathogen can be transmitted in a variety of ways because it is able to live in oxygen rich areas. It can be transmitted through any contact with infected blood with open wounds. Threat is medium to high dependant on the strain. Chance of microbial resistance is high in addition to increasing more in addition to more, so it is getting harder to treat. REFERENCES “Endocarditis – cardiologychannel.” Cardiologychannel, Your Cardiology Community – Physician-Developed – Cardiovascular Health Info – cardiologychannel. 12 Mar. 2009 . “Enterococcus faecalis -.” Wikipedia, the free encyclopedia. 12 Mar. 2009 . “Infective endocarditis -.” Wikipedia, the free encyclopedia. 12 Mar. 2009 . Leboffe, Michael J., in addition to Burton E. Pierce. A Photographic Atlas as long as the Microbiology Laboratory. Null: Not Avail, 2004. “The pathogenicity of enterococci – Johnson 33 (6): 1083 – Journal of Antimicrobial Chemotherapy.” Ox as long as d Journals Medicine Journal of Antimicrobial Chemotherapy. 12 Mar. 2009 . Sagel, Ulrich, Berit Schulte, Peter Heeg, in addition to Stefan Borgmann. “Vancomycin-Reistant Enterococci Outbreak, Germany, in addition to Calculation of Outbreak Start.” Emerging Infectious Diseases 14 (2008): 317-19.

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