Clinical Problem Solving And The Division Of Infectious Disease

History: Martha Wilmington, a 74-year-old woman with a history of rheumatic fever while in her twenties, presented to her physician with complaints of increasing shortness of breath ("dyspnea") upon exertion. She also noted that the typical swelling she's had in her ankles for years has started to get worse over the past two months, making it especially difficult to get her shoes on toward the end of the day. In the past week, she's had a decreased appetite, some nausea and vomiting, and tenderness in the right upper quadrant of the abdomen.

Listed from healthline.com, these symptoms may consist of high fever, increasement in heart-rate, confusion, shock, paced breathing, and chills. Do so to be aware of these symptoms, for they also relate to many other diseases. The diseases may be listed as the flu, the common cold, and many more. So please do be aware of the given symptoms listed above.

She was previously healthy and unlikely acquired isolated MAI infection from other causes from atmosphere. Our patient also showed dramatic improvement with treatment. Our case illustrates the importance of thorough social and occupation history in diagnosing diseases, especially rate diseases for which effective treatment is

In the school they’ve been having a statistic cases of diphtheria, which trends out your daughter has been going to during the month. That should’ve seemingly been the reason why she got sick. 2,100 deaths have occurred freshly and more might occurred if there ain’t an antidote.

The criteria for diagnosis entails a child that has a fever for 5 days plus four out of five of the other criteria: bilateral conjunctiva injection without exudate, polymorphous rash, inflammatory changes in the lips and oral cavity, changes in extremities (peripheral edema, erythema of palms and soles), and cervical lymphadenopathy that is usually unilateral, anterior cervical (Burns, Dunn, Brady, Starr, Blosser, 2013). Since the ER already performed cultures, a urine study, CBC, and CMP, which were all negative, the next blood work that would be beneficial is a CRP and ESR to check the extent of inflammation. The results of the CRP and ESR can help guide the management of the patient to see if treatment is necessary. The condition may only need to be monitored with a series of echocardiograms, or treatment with IVIG may become necessary depending on the results of the echocardiogram. No matter if IVIG treatment is needed, an echocardiogram should be performed as soon as a diagnosis is made, and at two weeks and six to eight weeks after the onset of the fever to evaluate coronary, myocardial, and pericardial inflammation (Burns, Dunn, Brady, Starr, Blosser,

The most likely diagnosis I selected for the patient is diabetes mellitus type 2. The clinical presentation of diabetes mellitus type 2 includes an insidious onset where patients are initially symptomatic. The patient may present with pruritus and neuropathic complaints of numbness and tingling. Other complaints include polydipsia, polyuria and nocturia. The presentation of an infection such as vaginitis caused by candidiasis or a non-healing skin infection is often the first complaint (Dunphy et al., 2015). The patient’s history of her present illness includes a three-month history of fatigue, which she complains of not having much energy for daily activities as she once did. Complaints of increased urination along with increased feelings

• Inability to maintain sufficient fluid and calorie intake with 10% weight loss during the previous six months or serum albumin < 2.5 gm/dl

This started since she came back from her visit to India in this summer. Initially she suffered from joint pains, severe body aches, fevers and chills on daily basis. I took her to a Hematology and Oncology clinic where the doctor saw her condition and suspected that she might have a cancer. After running hundreds of tests, fortunately the doctors have confirmed that there is no presence of Blood Cancer. However, she was diagnosed with following viruses:

Although, the patient’s has recorded a borderline hypothermic temperature and has presented with cool, pale skin, this can be attributed to the fact that she was found lying outside in wet weather for an unknown period of time (Laoteppitaks & Wiener, 2013). The hypoglycaemia may have also contributed due to the patient’s decreased metabolic rate which impairs the muscles ability to produce adequate body heat through shivering, thus lowing the body temperature (Bullock & Hales, 2013; Queensland Ambulance Service, 2011). Olesen, Brokjaer, Wendelboe-Fisher, & Larsen (2014) and Palmiere & Augsburger (2014) suggests that the patient’s presentation of abdominal pain, nausea and vomiting is often induced by an underlying infection such as acute alcoholic hepatitis, pancreatitis or alcoholic gastritis; which can be attributed to the history of prolonged alcohol abuse (Ansstas, Robinson, Rubinchik, & Schade, 2014)

The patient is a 70-year-old gentleman who presents to the emergency room complaining of shakingm fever and chills for the past 1-2 days. The patient's been noticing increasing subjective fever and chills, which he feels, is worsening. He has an associated cough with productive sputum, which is greenish in color. He is known to have medical history normocytic anemia, non-insulin-dependent diabetes mellitus, a recent admission for posterior-inferior cerebellar infarct on the right side, history of right frontal infarct, systolic heart failure with ejection fraction of 20%, a history of ventricular fibrillation, he has an AICD in place. He is also known to have coronary disease and he has had coronary bypass grafting, dyslipidemia, hypothyroidism

Based off of the clinical symptoms as well as the lab workup, I believe this patient has an acute infection with mononucleosis caused by Ebstein-Barr Virus (EBV). The patient’s white blood cell count is decreased at 2, and has an elevated band count indicating an infection is present. Furthermore, the EBV VCA IgM and IgG indicate a present EBV infectious mononucleosis (IM) (Mayo Clinic, 2017). It is not uncommon for the monospot test to be a false negative. The patient has the classic triad symptoms of mononucleosis along with a positive antibody test indicating a current infection (Mayo Clinic, 2017). If the patient had an elevated EBV VCA IgG without a positive IgM that would indicate a past exposure to infectious mononucleosis caused by

Stella is a previously healthy 47 year-old woman. She has been experiencing chest pain and a persistent cough. She thinks that she saw a bit of blood during the last coughing fit. She has tried Tylenol cold and flu and drinking cold water, because she suspected she had a cold.

One way the serodiagnosis of an irresistible malady can be built up is by gathering serum tests at two eras: amid the acute and the convalescent phases of the patient's sickness (Morello, et al., 2013, p. 298). Preferably, the acute specimen is gathered amid the symptomatic phase of sickness and the healing example is gathered possibly 14 days after the fact when the patient is recuperating (Morello, et al., 2013, p. 298). Together, acute and convalescent serum examples are alluded to just as paired serum examples (Morello, et al., 2013, p. 298). Paired samples are tried in the meantime in the serology research facility for the nearness of particular antibodies against the specific microbial specialist suspected to have caused the patient's ailment (Morello, et al., 2013, p. 298). The level or grouping of immunizer increments or abatements more than a little while (Morello, et al., 2013, p. 298). On the off chance that antibodies are

The term afebrile means one who does not have a fever, while febrile defines a client with a fever. Moreover, extremely high temperatures, such as a fever greater than 105.8oF (41oC) is referred to a hyperpyrexia. There are four common types of fevers intermittent, remittent, relapsing, and constant. During the intermittent fever the temperature fluctuates between high and normal temperature, this can be seen in clients suffering with malaria. Remittent fever occurs over a 24-hour period and fluctuates at elevated levels more than 2oC (3.6oF). Relapsing fevers are short fevers over a few days with periods of scattered normal temperatures. A constant fever remains above normal with slight fluctuations as seen in clients with typhoid fever. Clients with bacterial blood infections can have a fever spike which rapidly raises the temperature and returns to normal within a few hours. Heat strokes and heat exhaustion can cause a false fever. Symptoms of fever include but not limited to, an elevated heart rate, increased respiratory rates, shivering, increased thirst, dehydration, weakness, convulsions and sweating. To assist the client, give an ordered antipyretic, monitor the vital signs, white blood cell count, and hematocrit level. Moreover, provide nutrition and fluids to prevent dehydration while, measuring intake and output. In addition, remove unnecessary blankets and reduce

An eight year-old Hispanic girl arrives at the UF health emergency room with a stiff neck, vomiting, and seizures. Her sister, who brought her in, informs the doctor about the recent activities the girl has been involved in. She tells them that in the last 2 days, they have been going for a swim in the lake by their house since it is the summer time. She then continues and tells them that the evening after going for a swim, her little sister had been fussing about a throbbing head ache and sudden loss of taste. Ultimately, they brought her in after the girl experienced a small seizure. The doctor on call suggested that the signs and symptoms presented paralleled acute bacterial meningitis.