Mers Cov Contamination

EH is a 68-year-old male who comes into the clinic complaining of a fever with a temperature of 103 °F. He has had a cough for the last three days that is producing some thick green brown mucous. The MD feels he most likely has bacterial pneumonia. He also has a history of having rheumatoid arthritis, and being immune compromised as he is on an immunosuppressant methotrexate. He has noted that over the last year he has lost weight unintentionally and feels he is underweight.

Middle East Respiratory Syndrome (MERS) is a severe acute respiratory illness caused by the coronavirus named MERS-CoV. It is believed that the virus is found in camels and passed on to humans who are in contact or around infected animal. These camels are mainly located in Egypt, Oman, Qatar, and Saudi Arabia (WHO, 2015a). Those infected with MERS exhibit fever, cough, and shortness of breath, pneumonia, and diarrhea. Severe cases require patient to be put on mechanical ventilation or in an intensive care unit. It is also known to cause kidney failure and septic shock. The elderly, persons who are immunosuppressed, those who

In September of 2012, beginning in the country of Saudi Arabia, hospitals began seeing increased cases of a respiratory virus never before seen in humans. They named it Middle East Respiratory Syndrome, or MERS. MERS is a viral respiratory illness caused by the coronavirus. It was originally thought to have started there in Saudi Arabia. It was not until later that they were able to trace the origin back to Jordan starting in April of 2012. All outbreaks of MERS have been traced back to originating from the Arabian Peninsula (CDC, 2015a). Unfortunately, it is not known exactly how MERS was contracted in humans, but it is believed to have come from an animal source, probably from camels. Strains of MERS

SARS is a respiratory infection caused by the coronavirus that was thought to have originated in Guangdong China but was not reported until

Another Consultation Report dated 12/06/2016, indicated that the claimant presented with exacerbation of COPD, acute bronchitis, and pseudomonas aeruginosa. The CT scan of the chest revealed bilateral lower lobe atelectatic changes, fibrosis, and a small 1 cm left lower lobe nodular density. A pulmonary consultation was recommended. His blood pressure was 142/79 mmHg. The physical examination revealed bilateral decreased breath sounds and scattered wheezes. His glucose was 189. DuoNeb, IV Solu-Medrol, and IV antibiotics were prescribed.

Acute tonsillitis is inflammation of the tonsils secondary to an infectious process causing painful swallowing and is more commonly attributed to a viral cause rather than bacterial (Shepherd, 2013). A physical assessment of the tonsils may reveal an increase in size with edema and erythema. This is often associated with upper respiratory symptoms like, headache and cough (Shepherd, 2013). Another diagnosis is pharyngitis. Pharyngitis is also a sore throat which is secondary to inflammation noted at the back of the throat and associated with complaints of pain when swallowing (Shepherd, 2013). Viral pharyngitis is the most common and can be contributed to the rhino or coronavirus which lasts between 5-7 days and presents with associated symptoms like cough, headache, fatigue and mild fever (Ruppert & Fay, 2015). Finally, GABHS or more commonly noted as strep throat is a potential diagnosis. This bacterial infection is most common in children and adolescents. Often individuals present with symptoms including throat pain, fever, chills, headache, cervical lymphadenopathy and exudate noted to tonsils or in the pharyngeal (Ruppert & Fay, 2015). This infectious process in younger children may also present with gastrointestinal symptoms like nausea, vomiting and abdominal pain but is not accompanied by cough or nasal

Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or

a bacterial infection has occurred(Carson-DeWitt). Fever and discomfort can be helped by taking acetaminophen (Carson-DeWitt). A cool mist vaporizer may help with the cough (Carson-DeWitt). Fever leads to dehydration, therefore patients must be given lots of fluids and liquids to stay hydrated(Carson-DeWitt).

I have read a case review about the MERS-CoV, comparing between a negative MERS-CoV sample, who were the control group, and a group of positive MERS-CoV patients. The Study intended to try to find and determine clinical predictors that would make it possible to differentiate between positive and negative MERS-CoV cases that has community acquired pneumonia (CAP). I think that this case study was intended for medicine related patients. Some of the major findings of this case study are, the median duration of hospitalization was a lot higher for cases who had MERS to those who didn’t. Likewise, patients with MERS were more likely to have normal white blood count as opposed to the MERS negative patients. On the contrary, on admission, MERS positive

Severe Acute respiratory syndrome (SARS) is a respiratory illness that had recently been reported in Asia, North America, and Europe. SARS was first reported is Asia in February of 2003, over the next few months it spread to more than a dozen countries. By late July 2003, no new cases were being reported and the global outbreak was declared over by the World Health Organization. During this time period 8,098 people worldwide became infected with SARS and out of these 774 died. In the United States a total of 192 SARS cases had been reported, including 159 suspect and 33 probable cases. Of the probable only 8 had laboratory evidence of SARS-CoV infection. Luckily, no SARS relate deaths occurred in the US.

Mrs. A (pseudonym) is an 83-year-old Samoan female of Christian religion who was admitted to an urban hospital on 02/04/15 by GP referral. She came in with chest pain associated with productive cough and shortness of breath (SOB) on exertion. She also complained of having recurrent episodes of vomiting mixed with saliva and fatigue. She has a history of asthma, hypertension, type 2 diabetes mellitus on Metformin and double incontinence due to a long-standing history of intermittent constipation. Her chest computed tomographic (CT) revealed right lower lobe opacity indicating pulmonary consolidation, which means that her right lower lung has accumulated exudates in the alveoli that would have normally been filled by gas, indicative of bacterial pneumonia. Furthermore, a sputum gram stain sample collected from Mrs. A showed gram-positive bacteria, which is also a characteristic of pneumonia. Her blood tests revealed a high haemoglobin count, which may be caused by an underlying lung disease, as well as high white blood cell count confirming the presence of infection. Considering all diagnostic results, Mrs. A was diagnosed with right lower lobe bacterial pneumonia.

A number of studies have supported the theory that the virus had originally occurred in animals previous to human infections.5 The MERs-CoV virus is a type of coronavirus that has been known for infecting both birds and many species of mammals. These types of infections are commonly referred to as zoonotic diseases because the pathogens are able to be transferred from animals to humans. Zoonosis can happen with or without a vector in order to spread the infection. Although the exact origin of the MERs-CoV infections is unknown, there has been convincing research performed that has found related types of coronaviruses in bats and camels. According to the Center for Disease Control and Prevention, the coronavirus is found in multiple species and can cause respiratory illness and gastrointestinal upset.

"The common clinical features among the case-patients included a prodromial illness of fever, chills, and myalgia. The prodrome was followed by dyspnea, cough, throbocytopenia, severe hemodynamic instability, neutrophilid with immature forms, atypical lymphocytes, elevated serum levels of lactate dehydrogenase. There was a high mortality rate, approximately eighty percent in the initial group of patients, the chest x-ray examinations revealed a diffuse, interstitial infiltrate that resembled that observed in patients with adult respiratory distress syndrome (ARDS), which is a common pattern in patients

M. pneumoniae is generally referred to as primary atypical or walking pneumonia because the symptoms are not as sever as pneumonia. The symptoms include a dry hacking cough, fever, and headache. The symptoms will last for about 2 to 3 weeks. M. pneumoniae affects people worldwide. Typically only 33 % of people who have M. pneumoniae will get atypical pneumonia. The majority, 77 %, will come down with an upper tract infection (tracheaobronchitis). (Pulmonary Disorders pg 609) M. pneumoniae is transmitted through aerosol droplets. The bacterium is capable of infecting anyone at any time but it has a pattern of coming in the fall and winter and causing an outbreak every 4 to 8 years, although more tight communities occur more frequently. The pathogen rarely occurs on children less than 4 years of age. Since the bacterium lacks a cell wall, B-lactums are futile against them. The body’s immune system is responsible for killing the pathogen. There were 2 million cases in the US with 100,000 requiring hospitalization. The mortality rate is very low with only occasional fatalities among the elderly and sickle cell anemia persons. ( ).

Respiratory symptoms of this virus can be fever, cough, shortness of breath, and pneumonia. Patients can also have gastrointestinal problems such as diarrhea. If the patient becomes severely ill, they may have a respiratory failure and would be placed on a respirator or a ventilator. According to the World Health Organization (WHO) website, "Approximately 27% of patients with MERS have died." The organization also claims that the virus causes a severer disease in the elderly, people with a weak immune system, and people that may gave a chronic disease.