we have a patient who is 4 years old and was presented to thedoctor in early summer with a three-day history of vomiting andbloody mucus-flecked diarrhea. This little girl had many vomitingepisodes and ten bowel movements a day. she has pain while bowelmovement along with abdominal pain. she also has a fever of 40 Cwith chills. The girl has decreased fluid input and rain output.She had not recent camping history, no change in diet, no one athome has a similar problem, and no history of exposure to bad food.her physical examination was alert with vital signs within normallimits, normal skin color, and turgor, her skin was warm and dry.there was no lymphadenopathy. her abdominal examination was withinnormal limits, with normal bowel sounds d no organomegaly, guardingor rebound. A stool was guaiac positive and was sent for culture.She tolerated a popsicle challenge and was tolerating oral liquidswhen she was discharged home. Three days later the laboratoryreported that a non-factor fermenting nonmotile, H2s negativeorganisms was growing on MacConkey agar from the patient stoolspecimen. when her dad received the phone call her diarrhea hadbeen resolved.
1) what is your clinical impression of this child?
2) what is a stool guaiac test? do you think it had anyinfluence on the clinical decision to perform a stool culture?please explain?
3) what organism do you think caused her Diarrhea ? was herclinical pre sensation consistent with the organism? what virulencefactor does this organism produce that could explain her clinicalsymptoms? explain?
4)This child was treated with an oral cephalosporin. what this agood idea? explain
5) what was the significance of the popsicle challenge?
6) the Organism that infected this patient is a frequent causeof child care center outbreak of diarrhea. what characteristic doesthis organism have that makes it easy to spread in a daycaresetting? name two interventions that you would institute to try toend an outbreak of this organism in a child care center?
