• Case A 42-year-old male came with a history of a fall from the bike 7 days earlier. He had fallen into a drainage cana

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Case A 42 Year Old Male Came With A History Of A Fall From The Bike 7 Days Earlier He Had Fallen Into A Drainage Cana 1 (146.91 KiB) Viewed 42 times

• Case A 42-year-old male came with a history of a fall from the bike 7 days earlier. He had fallen into a drainage canal containing stagnant water and sustained injuries on the head and both the legs. His head and face had been submerged in the drain water. He also gave history of loss of consciousness for half an hour. He was nondiabetic and normotensive but was a chronic smoker. After the incident he was taken to a local hospital where the wound over the scalp, measuring about 6 × 1 cm, was sutured and the abrasions on the legs dressed. He had been discharged with oral Ampiclox™ 500 mg TID on the following day. Over the next 5 days he developed pain and oedema over the sutured area and was admitted to our hospital on the seventh day post injury. On examination, the patient was conscious and alert. His vitals were normal. Local examination showed a wound that was oedematous and discharging pus. The sutures were removed, and a pus sample aspirated with aseptic precautions and sent to the microbiology laboratory for bacteriological culture and antimicrobial susceptibility. The routine laboratory investigations showed: haemoglobin, 13.6 g/dl; total white blood cell count of 13000 cells/mm3, with 80% neutrophils; and fasting blood sugar, 70 mg/dl. CT scan (brain) was normal. Gram stain of the sample from the wound showed plenty of pus cells along with gram- negative pleomorphic rods. ▪ Answer the following questions 1. What was the source of the patient's infection? 2. Chromobacterium violaceum is arginine decarboxylase positive but not lysine and ornithine. What is the principle of these decarboxylation reactions? 3. Describe the principles and processes for collecting an aspirate specimen. What is/are the acceptance/rejection criteria that would be used to assess sample quality? 4. Did the patient's clinical findings correlate with the entire spectrum of the patient's laboratory findings?