case study 9 pathogenic bacteriology 2009
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Case Study 9 Pathogenic Bacteriology 2009. Omar Ahmed Hank Hsieh Rochelle Songco. Case Summary. 5 ½-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)

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case study 9 pathogenic bacteriology 2009

Case Study 9Pathogenic Bacteriology2009

Omar Ahmed

Hank Hsieh

Rochelle Songco

case summary
Case Summary
  • 5 ½-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
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
The Diagnosis for Case 9
  • Bordetella pertussis
  • Nasopharyngeal swab shown below

source: faculty.matcmadison.edu/mljensen

classification gram stain results and microscopic appearance of bordetella pertussis
Classification,Gram Stain Results, and Microscopic Appearance of Bordetella pertussis
  • Genus: Bordetella
  • Gram-negative
  • Coccobacillus
  • Aerobic

source: historique.net/microbes

diseases and pathogenesis of bordetella pertussis
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
Diagnosis/Isolation/Identification/ of Bordetella pertussis
  • Diagnosis based on…
    • repetitive coughing with choking, vomiting, and gasping for breath
    • Elevated pulse and respiratory rate
    • Elevated lymphocyte levels
      • Caused by a blocking of homing of lymphocytes to the spleen and lymph nodes
    • Culture from nasopharyngeal swab is most common method of detection due to the bacterial presence in nose and throat
      • Bordet-Gengou medium
      • Charcoal-horseblood agar
      • Detection of Bordetella DNA by PCR
      • Detection of IgA antibodies with ELISA
therapy prevention and prognosis of patient infected with 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
slide9
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. Control group of 11 infants with non-pertussis related hospital admission.
  • Full blood counts conducted for WBCs and also test of cell origin (lymphoid, granulocytic, or monocytic).
  • Patients with B. pertussis infection showed a much higher absolute number of neutrophils, monocytes, and lymphocytes compared to control
    • L-selectin is removed from leucocytes by pathogen
      • Prevents migration of leucocytes and homing and invasion of T and B cells to peripheral lymphoid tissues
  • Leukocytosis is consistent with an infection of Bordetella pertussis
take home message bordetella pertussis
= Take Home Message =Bordetella pertussis
  • Pertussis is a respiratory infection which causes “whooping cough”
  • Typical symptoms are initially cold-like followed by a stage of rapid coughing and finally a recovery stage of coughing which can last for weeks or months.
  • Pathogen which causes this infection is Bordetella pertussis
  • Diagnostics include a nasopharyngeal swab culture, DNA PCR, and ELISA test for antibodies
  • Erythromycin is the primary antibiotic used against an pertussis infection
  • Most children recover from the illness but pneumonia, apnea, encephalopathy, and rib fractures are complications associated with a pertussis infection
  • Immunization is effective against pertussis infections
  • Disease is spread by coughing and sneezing
  • Non-vaccinated infants and adolescents at most risk
references
References
  • "Bordetella". National Center for Biotechnology Information. March, 09, 2009 <http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mme d.chapter.1684>.
  • "Vaccines VPD-VAC-Pertussis-main page". Centers for Disease Control and Prevention. March, 08, 2009
  • "Pertussis Bacterial Infections Merck Manual Home Edition". MERCK. March, 07, 2009 <http://www.merck.com/mmhe/sec23/ch272/ch272g.html >.
  • McQueen, Nancy. Winter 2009. Bordetella, Francisella, and Brucella
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