CASE 2
A 30-year-old woman who is a recipient of a renal transplant was doing well on cyclosporine, azathioprine and prednisone. She presented to the hospital with complaints of fever, headache, inability to concentrate and anxiety. She had not been exposed to any other person who was ill, has no pets and has not traveled outside of Chicago. She did have Mexican style soft cheese about 2 weeks prior to her present illness. On examination she had a temperature of 39°C was very anxious and fidgety, but there was no clinical localization of infection. Analysis of the CSF revealed 100 lymphocytes, protein of 90 mg and sugar of 30 mg. Cultures of blood and CSF grew Listeria monocytogenes. The patient was treated with ampicillin, which caused a rash. Treatment was changed to Trimethoprim/Sulfamethoxazole. She improved rapidly and was discharged home.
1. Describe succinctly the disease this case represents Answer
2. Describe the offending organism of this case, its morphologic, cultural characteristics and their normal habitat. Answer
3. What kinds of hosts are susceptible? Answer
4. How do these organisms gain access, invade and spread in humans? Answer
5. What defenses humans have against these organisms? Answer
6. How do these organisms able to overcome human defenses? Answer
7. What is the end result of this battle between organisms and humans? Answer
8. How do you diagnose this infection? Answer
9. What will be your therapeutic strategy? Answer
10. How can you prevent it from spreading to others? Prevent its occurrence? Answer
11. What are other clinical infections with these organisms Answer