A 23-year old female walks into a small-town medical clinic complaining of malaise, fever and chills, dry cough, and myalgia.Upon examination, she has a temperature of 38.5 C, blood pressure of 100/62 mm Hg, pulse rate of 110 beats per minute, and a respiratory rate of 38/minute. She also reports chest and abdominal pain.
1. What bacterial/viral diseases might cause these symptoms? (Give your differential diagnosis of four diseases that this case study might be based upon.)
2. The doctor ordera a chest X-ray and cultures her throat and nasopharynx. He also does some rapid serological tests. No diagnosis is made at this time, so he sends her home and waits for test results to decide on treatment.
3. When the results are called to the patient in two days, she tells the nurse she's feeling worse, with higer fever, acute dyspenea, and cyanosis. The chest X-ray shows infiltrates and mediastinal widening. The culture shows large, box-car-like, Gram positive rods with "holes" in the center of them.
What disease do you now know this is? What is the etiologic agent and how was it acquired? What are the "holes" in the microbes and how can they be better visualized?
Why are antibiotics ineffective at this time in the disease process? What virulence factors are involved in this disease? Explain in detail what they are and how each particular one affects the body.
Fully describe how this disease can be prevented.
Why is this a good weapon for bioterrorism? What other microbes might be good bioweapons and why?
Don't forget to properly submit your references with each answer!