Exercise 19.

1: C0sfO
Clinical case: A40 yr old male presented with the history of passing rice watery stool and signs of severe
dehydration, from a village near kolar which had an outbreak of acute diarrhea. Stool | sample was sent for
investigation to the nearest Microbiology Laboratory. The specimen (A) was subjected to grams stain(B)
culture(C, D) and biochemical reactions(E), aglutinations (F)with the antisera.
1. ldentify the probable clinical diagnosis and causative agent. Justify your answer
Siagnetu- (hola
e debydatio ad oiauhea
Cauatiu thaanAm
2. Name one simple and quick preliminary diagnostic test for this condition

3. Suggest tests to confirm the most probable pathogen

Kien ladoaing ing det

4. The patient is in'a'vlane and nearest microbiblogý lab isposihue
20 kms.from there. Describe appropriate
sample collection and transportation procedures for identifying the probable pathogen. Suggest
alternative optionsfor the same
- 8ted
Veu kata Aaman
Autoclauud sea ate,
Rama kishnan medin
-Renta
5. Based on the clinical features
provided and laboratory tests displayed suggest
in order of preference appropriate treatment

6. Nam¿3 other possible pathogens

responsible for such condition.

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Exercise 19.2:a
Clinical case: Atwoyear old child with diarrhea was admitted to pediatric ward with fever and signs of
dehydration (A). Stool hanging drop preparation showed no darting motilty, stool microscopy had no pus
cels, HBUs, ova and cyst. And no bacterial pathogen was isolated from stool culture. But there was
significant finding was seen in electron microscopy.
1. ldentifythemost probable pathogen in this case

2. Name other tests to confirm the laboratory diagnosis

DAat detetin

and latay
3. Name the other organisms causing similar clinicalmanifestations

Aduaehus
Adstehus
4 List the laboratory teststodifferentiate other pathogens causing this condition
tucf haugiug daep taawt
8toot ultie
batiinal tat ultue media -Neghaath. Dìst TEM - Shap edgt tiple
Ati det ten FUSA and latLx
5. Describe briefly specific preveDtive measures for thiscongition
Nacine"Rtowae contas atenuated Rtai i6E
aggluthaton.
Maulastued by Blauat
oleng with pT ahd DPv. Aittah 3 dote aduninitd ptally at 6 oej4 naety
Ratdaiy contina

Tnnpoyd Soutation tte Conity

6. Alocal doctor has prescribed Syp. Amoxycilin-clavulanic acid in appropriate dose and frequency for 3
days. Is it justified?

and adulanieaid ill

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 Exercise 19.3: clostiioder cfce
Clinicalcase: A38 yrs female was admitted to female ward with loose stools since one week and aives a
history of taking broad spectrum antibiotics ceftrioxone and clindamycin ten days for lower respiraton
tract infections. Stool routine was inconclusive, stool sample was sent for detection of toxins and
glutamate dehydrogenase antigen.

1. ldentify the probable etiological agent in this case

2. Describe the pathogenesis of this condition in brief

bauhd endelexin Toxin A(Enus taxcin

3. Enumerate other risk factors associated with this clinical condition Rsdidonbrouaus colia).

gatie ald sppreision madicatin

malgmaat gstaiteatinal
4. Suggest principles of treating this condition bioad speotaum autibintu

130
 Exercise 19.4: Aindii
Clinicalcase: A30 yrold male presented with recurrent episodes of foulsmelling stool with mucus,foul
Tiatus, sulfurous belching and profound weight loss. His stool wet mount showed few oval shaped cyst.
1. Draw and label the two diagnostic forms of this organism

Nul
Sucking

Pansbaal| Nud
body

-Paqdla(thotoia)
Ayoneme
Giandia ammblia tophozeit Giondia lamblia yt
(front wiew)

2. Suggest other samples and tests that can be

- &teteyamihen Cmiescopy) cenid done to
diagnose this clinical condition
as ste,9 ed ataudad f
diagovs
Dusd
Ciadias, alach ditact he
opng
kUSA oo diilet uousce
Jauttbody tests wsing labed heonsconal autbeaie
ndihutt Haiotyct
J. Name the intective forpmof this organism anmtt awtibiies ÂALSLGcyaaol EUSA
mode oftransmission a PCR

tuausnaissien Bate enlanin fed matue and

4. ERúmerate complications of this infection hooeuals

Phofouad
Uaticaia
gest Atandatimm
Athitib
Rtinal clegc Anteio weihs

132
5. Suggest treatment for this condition
Tinidazee of cheie
Mernidazele t

Exercise 19.5: gropowdium

Clinical case: An AlDS patient with chronic waterydiarrhea and has features of severe malnutrition. HIs
stoolwet mount showed round structures and modified acid fast staining was done.
1. ldentifty the etiological agent in this case

madided Af shened ecust aonded Rec coleued

ize

2. Enumerate other similar organisms causing this type of clinical presentation

3. List other laboratory tests to diagnose this condition

hatigeu cdetcten
Aaa pattuelegîcal xauinatol
PCR
4. Describe the mode of transmission of this infection and suggest preventive measures
Macle o dewnalasiem gutam trod aud oatu cgrtaminated soitt
tick salled hutpinetion with ttu
Contouinatd
Phapt faandash
we' o waleftu
J 'of duine taut
Jmgroled pelsonal hgiene.

133