Case Study 9Pathogenic Bacteriology2009.ppt

Case Study 9Pathogenic Bacteriology2009 Omar Ahmed Hank Hsieh Rochelle Songco Case Summary 5 ?-week-old male 10 day history of choking spells Repetitive coughing, turning red, gasping for breath Vomiting associated with choking spells in prior 2 days Pulse – 160 bpm (elevated) Respiratory rate – 72/min (elevated) Chest radiograph is clear and trachea is normal White cell count – 15,500/μL with 70% lymphocytes Key Information Pointing to Diagnosis An elevated white cell count with 70% lymphocytes Coughing spells, turning red, gasping for breath Episodes of vomiting Chest radiograph is clear indicating no pneumonia infection No tracheal abnormalities These are all consistent with a pertussis infection The Diagnosis for Case 9 Bordetella pertussis Nasopharyngeal swab shown below Classification,Gram Stain Results, and Microscopic Appearance of Bordetella pertussis Genus: Bordetella Gram-negative Coccobacillus Aerobic Diseases and Pathogenesis of Bordetella pertussis Pertussis, which causes whooping cough Infection of the respiratory tract Children and young infants are most at risk Most contagious before coughing begins Diagnosis/Isolation/Identification/ of Bordetella pertussis Therapy, Prevention and Prognosis of Patient Infected with Bordetella pertussis Erythromycin is the drug of choice against a pertussis infection Reduces duration by 5-10 days but not the course of the infection Bacteria is slow growing so cough persists DTaP vaccine available for children Reported cases down 97% from pre-vaccine era Tdap booster vaccine for adolescents and adults A marked decrease in L-selectin expression by leucocytes in infants withBordetella pertussisinfection: leucocytosis explained? Hodge, Greg, et al, 2003, A marked decrease in L-selectin expression by leucocytes in infants withBordetella pertussisinfection: leucocytosis explained?, Respirology, 8: 157-162. Blood collected from 11 infants with B. pertussis infection prior to antibiotic therapy.