A The patient was a 32-year-old Haitian male referred to the hospital with a 3-week history of fever, nausea, vomiting, and diarrhea.

A The patient was a 32-year-old Haitian male referred to the hospital with a 3-week history of fever, nausea, vomiting, and diarrhea. Four days after returning from Haiti, where he had participated at a funeral with unembalmed bodies, he developed a temperature of 39.50C, myalgias, constipation, and rectal pain. He was admitted to a hospital for an overnight stay and given LV. cefotaxime. He was discharged on oral cephalexin. His symptoms recurred 2 weeks later and his therapy was changed to metronidazole. Five days prior to his current admission the patient developed fever, diarrhea with 6 watery stools per day, nausea, and vomiting. On the day of the admission, the patient passed out Case History 7 pl is while walking to the bathroom. Al On admission to the hospital, he had a temperature of 37.7 o C, supine pulse rate of 104 beats/minutes, and blood pressure of 115/75 mm Hg; the standing pulse rate and blood pressure were 132 beats/minute and 90/60 mm Hg, respectively. The rest of the patient’s physical and laboratory findings were unremarkable. On the second day in the hospital, the patient became acutely agitated, pulled out his LV. lines, and tried to leave the hospital. He claimed a voodoo curse had been placed on him, and that he was already dead. Hepatitis and HIV serological tests were negative. Blood and stool samples were positive for a motile, Gram-negative rod, which fermented glucose Without gas formation, did not ferment lactose, and produced H2S during metabolism. Be th af pe The following questions are to be addressed in your paper: th of 1. What is the diagnosis for this patient? 2. According to your textbook, what other possible diagnoses should you have considered? What other diseases might have similar symptoms? 3. Which of the signs, symptoms, history, clinical exam, and laboratory findings were most important for you to make your diagnosis? What symptoms brought this patient to the clinic in the first place? Is this a common symptom with this disease? How common is it? 4. Are any particular people especially at risk for this disease? How is it transmitted? How prevalent is this disease? Can there be carriers? What happened on the Comell University campus conceming this disease? 5. What is the etiological agent (causative agent) of this disease? Give the major characteristics associated with this organism (shape, gram stain reaction, habitat, special properties of this organism). Does this organism cause other diseases? If so, what are they? 6. What properties (virulence factors) does this organism have that allow it to cause disease? How do they help the organism cause disease? p re is

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