TJ Porter was a 15 year old high school student with a new summer job working with a gardening crew. His main job activity was spreading bark mulch in garden beds. Last August he rapidly developed severe shortness of breath, a persistent cough, and chest pains. On admittance to the hospital, radiological examination revealed large “cotton ball” densities in both of his lungs. Culture of his lung aspirate grew Aspergillus fumigatus. TJ was given IV amphotericin B and assisted mechanical ventilation via a tracheotomy. He slowly improved in the hospital, but also contracted 2 other respiratory infections with Pseudomonas aeruginosa and Strep. faecalis. These infections were treated with appropriate antibiotics. TJ had 4 sisters and 2 brothers. One of his brothers had a perirectal abscess in infancy but otherwise has been well. TJ’s white blood cell count was in the normal range, with ~65% neutrophils, 30% lymphocytes, and ~5% monocytes. Serum IgG and IgM levels were in the normal-to-high range. What other information would you like to know before making a diagnosis? What is happening with TJ? How would you fix it?
TJ Porter was a 15 year old high school student with a new summer job working with a gardening crew. His main job activity was spreading bark mulch in garden beds. Last August he rapidly developed severe shortness of breath, a persistent cough, and chest pains. On admittance to the hospital, radiological examination revealed large “cotton ball” densities in both of his lungs. Culture of his lung aspirate grew Aspergillus fumigatus. TJ was given IV amphotericin B and assisted mechanical ventilation via a tracheotomy. He slowly improved in the hospital, but also contracted 2 other respiratory infections with Pseudomonas aeruginosa and Strep. faecalis. These infections were treated with appropriate antibiotics.
TJ had 4 sisters and 2 brothers. One of his brothers had a perirectal abscess in infancy but otherwise has been well.
TJ’s white blood cell count was in the normal range, with ~65% neutrophils, 30% lymphocytes, and ~5% monocytes. Serum IgG and IgM levels were in the normal-to-high range. What other information would you like to know before making a diagnosis?
What is happening with TJ?
How would you fix it?
Introduction :-
Pseudomonas aeruginosa is a gram-negative bacteria that can cause a wide range of infections in humans, including respiratory infections, urinary tract infections, and infections of the skin and soft tissue. It is commonly found in the environment and can cause infections in individuals with weakened immune systems, such as those with chronic conditions, such as cystic fibrosis, or those undergoing medical procedures, such as surgery or chemotherapy.
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