Transcript Case 7 - Cal State LA - Instructional Web Server

Case Study
#7
Pathogenic Bacteriology
Jose Cervantes Jr.
Partners:
Hien Dang
Evelyn Loi
Case Summary
 70-year-old female with multiple myeloma.
 treated with immunosuppressive drugs.
 2-day history of dyspnea
 a cough (white phlegm)
 low grade fever, elevated heart rate and leukopenia
 bilateral crackles with expiratory wheezes.
Key Information Pointing
to Diagnosis
 Age:
 70-year-old female
 History:
 1 year previously was diagnosed with multiple myeloma
 2-day history of dyspnea with cough producing white phlegm.
 Symptoms:





Fever of 38.8 C
Elevated heart rate: 120/min
Leukopenia: 1,700 white blood cell count
Chest auscultation revealed crackles and wheezes.
Chest radiograph showed diffused pulmonary infiltrates with
effusion.
Gram Stain Results
susceptible to Optochin
Sensitivity testing of
Streptococcus
Classification, Gram Stain Results,
and Microscopic Appearance
 Family: Streptococcaceae
 Genus: Streptococcus
 Species: pneumoniae
 Gram positive
 Cocci shaped bacteria
 Mucoid
 Irregularly shaped colonies
 α-hemolysis
Diseases and Pathogenesis
of Disease Caused by
 Diseases caused by this bacteria:
- pneumonia
- Sinusitis
- Otitis media
- Bacteremia
- Meningitis
Diagnosis,Isolation, and
Identification
 Biochemical Testing
 Optochin Test
 Is the only Strep. that is susceptible
 Bile Solubility Test
 bacteria will lyse and the area become clear
Virulence factors:
 Capsule- is the most important
 80 different types and antibodies agaist the
capsul and are type specific and protective




Leukocidan
Neuraminidase
Hyaluronidase
IgA protease
Therapy, Prevention and
Prognosis of Patient Infected
 Antimicrobial Therapy:
 Penicillin,
 Augmentin
 erythromycin
 Practice good hygiene:
 Get an influenza shot each fall.
 Get a pneumonococcal vaccine.
 Practice good preventive measures by eating a proper diet,
getting regular exercise and plenty of sleep.
 Do not smoke.
Primary Research Article
Contributing to the Understanding of
the Disease
Heffernan, Richard et.al, 2005, Journal of Infectious Diseases;
Incidence of Invasive Streptococcus pneumoniae Infections
among Persons with AIDS in an Era of Highly Active
Antiretroviral Therapy, 1995-2000. 6/15/2005, Vol. 191 Issue
12, p2038-2045, 8p
Experimental set up:
 used time-trend analysis of annual invasive pneumococcal disease
incidence rates from a population based, active surveillance system.
 Annual incidence rates were calculated for 5 July–June periods by
use of data from San Francisco county, Baltimore, and Connecticut.
 The numerators were the numbers of invasive Streptococcus
pneumoniae infections among persons 18–64 years of age with
AIDS; the denominators were the numbers of persons living with
AIDS, estimated on the basis of AIDS surveillance data.
FIG. 1
 (July 1995–June 1996) to 467 cases/100,000 persons living with
AIDS (July 1999–June 2000).
 The annual percentage changes in incidence were 34%, 29%, 8%,
and 1%. Declines were similar by surveillance area, sex, and
race/ethnicity.
 Conclusion:
 In the United States, invasive pneumococcal disease incidence
declined sharply across a range of subgroups living with AIDS
during the period after widespread introduction of HAART(highly
active antiretroviral therapy). Despite these gains,persons with
AIDS remain at high risk for invasive pneumococcal disease.
Take Home Message
 Disease Streptococcus pneumoniae involves…
Pneumonia, Sinusitis Otitis media, Bacteremia, and Meningitis
 Typical symptoms
 rapid breathing, rapid pulse rate,crackles and wheezes in lungs, pulmonary infiltrates with
effusion.
Pathogen is Streptococcus pneumoniae
 Diagnostics include test

Chest auscultation and Chest radiograph
 Treatment:

Penicillin, Augmentin, and erythromycin
 Prognosis:

 If S. pneumonia is left un treated could cause serious repercussions, however with treatment,
mortally rate is really low.
Prevention:



Transmission is via


Get an influenza shot each fall
Practice good preventive measures by eating a proper diet, getting regular exercise and plenty of sleep.
spread through contact with an infected person.
Threat is
 To immunocomprimised individuals (HIV ), very young, and very old people.
References
 Heffernan, R. et.al, Journal of Infectious Diseases; 6/15/2005, Vol.
191 Issue 12, p2038-2045, 8p Incidence of Invasive
Streptococcus pneumoniae Infections among Persons with AIDS
in an Era of Highly Active Antiretroviral Therapy, 1995-2000.
 McQueen, Nancy. 2009. Streptococcus Lecture.
California State University Los Angeles.
 http://www.healthscout.com/ency/1/205/main.html
 http://dhs.wisconsin.gov/communicable/FactSheets/Str
epPneumo.htm
 http://www.cdc.gov/NCIDOD/DBMD/DISEASEINFO/str
eppneum_t.htm