case study

  Case Study Infections of the Cardiovascular and Lymphatic System Toxoplasmosis……………..Don’t Blame Fluffy! As allotment of their charge to “going green,” Layla and Steve Jackson lived on a babyish acreage in rural northwest Pennsylvania. Steve chopped copse from their backwoods to bake in their Franklin stove, and about 25% of their electricity was generated by the wind turbines on top of their mountain. They aloft about all of their own aliment amid their babyish angel orchard, huge vegetable garden, and a drupe patch. The brace reared abundant sheep, a few pigs, and one dairy cow. These animals additional the rabbit, turkey, and deer Steve bolter added than covered their meat and milk needs. Although the adolescent brace admired alive their farm, to accomplish ends accommodated financially, they additionally accomplished at the bounded aerial school. Layla was a 10th brand algebraic abecedary and Steve served as both the choral and bandage admiral for grades 7–12. Unless the anchorage were icy in the winter, the “green team” biked the four afar to assignment every day. While this affairs kept them acutely busy, Layla and Steve acquainted abundant achievement alive their carbon brand was significantly beneath than that of the boilerplate American. As Layla best the blooming beans and baddest about the annihilate one July morning, she advised how their affairs would change in November aback their first adolescent was due to be born. She was admiring to be able to accession their adolescent in the antibacterial ambiance of their country acreage and attend him with acquaintance foods chargeless of the pesticides and preservatives begin in abounding commercially produced items. “Of course,” Layla said to herself while patting her belly, “I anticipate we’ll accept to breach bottomward and drive a little added this winter. You’ll be a bit too babyish for my babyish bike seat.” As if on cue, the babyish started “dancing.” Laughing, Layla calm the baskets of aftermath she had harvested and headed to the kitchen to alpha authoritative lunch. After rinsing the fresh-picked fruits and vegetables, Layla acclimated her garden’s compensation to accumulate a adorable bloom and bootleg birthmark shortcake with chrism from Josie, their cow. After that afternoon, the brace went to Dr. Schneider’s office for Layla’s account prenatal examination. They watched with admiration as the obstetrician acclimated ultrasound to admeasurement the baby’s growth, confirming that Layla was 23 weeks pregnant. Dr. Schneider acicular out altered appearance of their developing child. They saw a tiny assault affection and abstruse it was time to acrylic the nursery blue!                 Layla’s abundance progressed commonly until her abutting arrangement at 27 weeks gestation. Dr. Schneider was afraid to find Layla hadn’t acquired any weight in four weeks. “At this date of your pregnancy, you should be accepting about 0.5 to 1 batter per week,” Dr. Schneider said with concern. “Are you bistro abundant alimental foods?”  Layla was blessed to address a advantageous appetence that she consistently advantaged with the foods she and Steve raised. “I bet it’s the added exercise I’m getting,” Layla explained. “I’ve been canning aftermath as fast as I can autumn the garden and orchard. I’m up and bottomward the hillside a dozen times a day carriage a abounding bassinet basket, so I bet I’m aloof afire off the calories with my gardening.”  Dr. Schneider cautioned Layla not to be appropriation abundant baskets and encouraged her to add an afternoon bite to her accepted diet. “I appetite to see you in two weeks to be abiding your weight accretion is aback on track,” Dr. Schneider ordered. Absolutely one anniversary later, Layla alleged and appointed an burning appointment. For the antecedent 48 hours, Layla had accomplished significant airsickness and diarrhea. By the time she accustomed at Dr. Schneider’s, Layla was anemic and hardly dehydrated. Frantic, Layla arise a abatement in fetal activity. Dr. Schneider accepted Layla to the hospital for IV fluids and assigned medication to affluence her GI distress. What infections apparent with these symptoms? Are any specifically associated with pregnancy? An hour after Dr. Schneider performed an ultrasound to analysis on the advance of Layla’s developing son and was abashed to see no fetal advance aback her anniversary 23 examination. In the morning, Dr. Schneider accustomed at the hospital aboriginal to appraise Layla and her baby. Steve was comatose in a armchair and Layla sat up in bed complaining gently. She hadn’t acquainted the babyish move aback midnight. Dr. Schneider confirmed Layla’s affliction fears with addition ultrasound, which showed no fetal heartbeat. Labor was induced to bear Layla and Steve’s 28-week-old stillborn son. A fetal dissection arise animated titers of toxoplasmosis antibodies, hydrocephalus and academician lesions. Describe the adroit abettor of toxoplasmosis. Outline the activity aeon of this microorganism. A anniversary later, Layla and Steve met with Dr. Schneider to analysis the dissection address and acknowledgment their continued account of questions. “So, I got toxoplasmosis and that’s why I was so sick…and again I fabricated the babyish ailing too,” Layla said dismally. Were Layla’s affection connected with toxoplasmosis? Describe the accepted signs and affection of this infection. What is a accessory infection? “No,” Dr. Schneider replied, “not exactly. Your GI affection were casual and represent a accessory infection. They artlessly alerted us to the botheration with the baby’s growth. It does; however, arise you’ve been adulterated with toxoplasmosis and the antibody beyond the placenta to affect your baby. “Wait a minute,” Steve interjected. “How did Layla get toxoplasmosis? I’ve heard about this disease. Abundant women get it from alteration clutter boxes. We don’t accept a pet cat. In fact, we don’t alike accept beasts in our barn!” Are clutter boxes a antecedent of antibody transmission? Explain. What are the best accepted agency of toxoplasmosis transmission? Based on this information, was Layla at aerial accident for infection? How can toxoplasmosis be prevented? What is the prevalence of toxoplasmosis? “Dr. Schneider, was there any way to analyze and amusement my infection that ability accept adored our baby?” Layla asked. “There are altered analytic tests for toxoplasmosis, but they aren’t commonly run in a prenatal console in the U.S. unless we accept acumen to doubtable infection,” Dr. Schneider explained. “If a abundant woman is infected, several analysis protocols are available, but the benefits charge be anxiously advised adjoin the risks aback the likelihood of manual and fetal accident varies with the gestational age of the mother seroconversion How is toxoplasmosis about diagnosed? What challenges are associated with interpreting analysis results? How can fetal infection be determined? Describe the arch analysis protocols for toxoplasmosis infection in a abundant patient. Indicate the pros and cons of anniversary treatment. Aback is the best time during the advance of Toxoplasma gondii infection to administrate analysis to a patient? Explain the alternation amid the gestational age of affectionate seroconversion for toxoplasmosis and the accident of fetal infection. What signs and affection are bidding by neonates with complete toxoplasmosis? What affection are bidding by adulterated accouchement aural the first year of life? What is the abortion amount associated with fetal toxoplasmosis? “Now that I’ve been adulterated with toxoplasmosis, do I charge to be treated? If I’m convalescent can we still accept alternative children, or will I affect them too, causing addition miscarriage?” Layla asked hopefully. “Not to worry,” Dr. Schneider consoled the adolescent couple. “You’ve suffered a adverse loss, but I’m confident you’ll anon be parents.” Is it all-important to amusement Layla for toxoplasmosis? Can she accept consecutive accouchement after risking their infection? Anderson, R. Case abstraction in microbiology: A Personal Approach, Publisher: John Wiley & Sons Copyright year: © 2006.  Case Abstraction # 4 Sex, Drugs and Rock and Roll Jim was a badge officer and his wife Barb a assistant at the hospital that handled best of the city’s poor. It was assured that their paths would occasionally cantankerous during work. Tonight, they were both at a association beat affair apropos the problems acquired by the access in clear meth use. Methamphetamine, or clear meth, is a effectively addictive analeptic that has an acute euphoric effect.  Jim saw its aftereffect aback abiding clear meth users would commence on binges of connected meth use. The after-effects were universally disastrous––intense paranoia, beheld and audition hallucinations, and berserk out-of-control behavior. Barb saw addition ancillary of corruption of the drug. Clear meth use has a almighty aftereffect of accretion the sex drive. As a result, clear meth users were added acceptable than others to appoint in high-risk animal behaviors and accept added animal ally than nonusers. Barb had apparent a significant access in cases of gonorrhea in general, and increases in syphilis and HIV ache amid gay men. Long-term users of clear meth body up a altruism to the drug. As a result, abounding accept to inject the biologic to abide to get high. Not unsurprisingly, intravenous biologic use increases the advance of HIV as users allotment all-overs (and accordingly barter babyish amounts of blood). At counseling programs advised to advice HIV-positive gay and bisexual men who use clear meth, about bisected had injected meth during the aftermost year. Neither Jim nor Barb was the blazon to sit aback and achievement for the best. They had abundant invested in their association area their accouchement went to school. Both were connected volunteers. Jim already accomplished soccer and led scouts. Barb was alive at their abbey and volunteered to advice acceptance with account and algebraic at school. At the end of the meeting, both took allotment in the altercation and planning sessions on how to advice the association axis the problems acquired by boundless crystal meth abuse. What types of behaviors are advised aerial accident for accepting sexually transmitted infections? What bacilli are amenable for causing these STI’s? Describe each. What are the analytic signs and affection of gonorrhea? Compare them to those acquired by syphilis. What alternative STIs would you apprehend to be added afterward an access in high-risk animal behaviors and an access in animal partners? In general, how can the advance of STIs be reduced? Are the activities bare to anticipate or abate the advance of STIs acceptable to be followed by clear meth users? What recommendations would you accomplish to Jim and Barb’s association accumulation to advice abate the advance of STIs amid the clear meth users? Anderson, R. Case abstraction in microbiology: A Personal Approach, Publisher: John Wiley & Sons Copyright year: © 2006. 

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