A Compilation of Comprehensive Reviews on Clinical Focus

In partial fulfilment of the requirements in Microbiology and Parasitology

Submitted by:
Parreño, Juvesmar V.

Submitted to:
Mr. Kenneth Benignos
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

TABLE OF CONTENTS
Clinical Focus 1

• ……………………………………………………………………………2

Chemical Focus 2

• ………………………..……….………………………………………….3

Clinical Focus 3

• ……………………………….........……………………………………...4

Clinical Focus 4

• …………………..……………………….………………………………..5

Clinical Focus 5

• …………………………………………………………….………………6
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

Clinical Focus 1:
Introduction
Cora, a 41-year-old lawyer and mother of two, presented with severe headaches, a high fever,
and a stiff neck. Her husband reported episodes of confusion and unusual drowsiness, leading
to a suspicion of meningitis, an infection affecting the brain and spinal cord's surrounding
tissue.
Assessment
Signs and Symptoms
● Severe headaches
● High fever
● Stiff neck
● Confusion
● Unusual drowsiness
Diagnosis
Diagnosis: The doctor initially suspected meningitis, ordered a lumbar puncture, and further
tested the CSF samples. As the bacterial and fungal causes were ruled out, the diagnosis
shifted towards a viral infection affecting the central nervous system.
Planning
Antibiotics were prescribed based on clinical suspicion despite negative CSF cultures.
However, Cora showed no improvement, prompting further investigations to rule out
alternative causes.
Implementation
Additional tests were conducted on the CSF samples to explore other potential infections or
underlying conditions contributing to Cora's symptoms.
Evaluation
The doctor will evaluate Cora's response to treatment, monitor her symptoms closely, and
adjust the treatment plan as needed to ensure her recovery.
Conclusion
The case highlights the complexity of diagnosing meningitis, especially when initial tests
yield inconclusive results. Cora's evolving symptoms necessitate ongoing evaluation and a
multidisciplinary approach to determine the precise cause and guide appropriate
management.
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

Clinical Focus 2:
Introduction
Barbara, a 19-year-old college student residing in a dormitory, presented with symptoms
including sore throat, headache, mild fever, chills, and an unproductive cough. Despite initial
self-medication with over-the-counter cold medication, Barbara's condition worsened with
persistent cough, fever, fatigue, and weakness.
Assessment
Signs and Symptoms
● Sore throat
● Headache
● Mild fever
● Chills
● Unproductive cough
Diagnosis
The PA determines Barbara's illness to be pneumonia based on her symptoms and diagnostic
findings.
Planning
● Ordering a chest radiograph to visualize lung abnormalities
● Prescribing amoxicillin, a penicillin derivative, for bacterial pneumonia
Implementation
The PA prescribes azithromycin or doxycycline as an alternative antibiotic treatment for
Barbara's pneumonia, along with supportive care recommendations.
Evaluation
Barbara will be monitored for improvement in symptoms and recovery from pneumonia
following the new treatment plan.
Conclusion
Barbara's case highlights the complexity of pneumonia diagnosis and treatment, necessitating
close monitoring and consideration of alternative pathogens and therapies in cases of
treatment failure.

Clinical Focus 3:
Introduction
Sarah is a 7 year old and upon arriving from school, she complains that a large spot on her
arm will not stop itching.
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

Assessment
Sarah presented with a red circular spot with a raised red edge on her arm that was itching
persistently. Upon examination with a Wood's lamp, it was confirmed that she had ringworm,
a fungal infection.

Diagnosis
Sarah presented with a red circular spot with a raised red edge on her arm that was itching
persistently. Upon examination with a Wood's lamp, it was confirmed that she had ringworm,
a fungal infection.

Planning
The physician explained to Sarah’s mother that ringworm is a fungal infection that can be
transferred through touch and contact with contaminated objects. He reassured them that
while it is common among school children due to close contact, it is treatable with antifungal
medication.

Implementation
To confirm the diagnosis, the physician performed a microscopic examination of a specimen
scraped from the lesion. The presence of fungal elements, such as macro- and microconidia,
confirmed the diagnosis of ringworm caused by Trichophyton rubrum.

Evaluation
It is important to monitor Sarah's response to the antifungal treatment to ensure that the
ringworm clears up. If the symptoms persist or worsen, further evaluation and possibly a
different treatment approach may be needed.

Conclusion
In conclusion, Sarah’s case of suspected ringworm was diagnosed promptly through clinical
examination and microscopic analysis. With appropriate treatment and adherence to hygiene
measures, Sarah is expected to recover fully from the fungal infection.
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

Clinica Focus 4:
Introduction
David, a 45-year-old journalist, recently returned to the U.S. after traveling through Russia,
China, and Africa. He visited his general practitioner due to weakness in his arms and legs,
fever, headache, noticeable agitation, and minor discomfort, which he suspected might be
related to a dog bite he received while interviewing a Chinese farmer. He also experienced
prickling and itching sensations at the bite site.

Assessment
Signs and Symptoms
● Weakness in arms and legs
● Fever
● Headache
● Noticeable agitation
● Minor discomfort
● Prickling and itching at the site of the dog bite

Diagnosis
The doctor diagnosed David with rabies infection based on the positive blood test for rabies
virus antigen.

Planning
Based on the diagnosis, the doctor planned prophylactic treatment for rabies:
● Human Rabies Immunoglobulin -Administered through intramuscular injections to
provide immediate passive immunity.
● Rabies Vaccines -Administered in a series to induce active immunity against the
rabies virus.

Implementation
David received the prescribed prophylactic treatment, including human rabies
immunoglobulin and rabies vaccines, as planned by the doctor.

Evaluation
The immunofluorescent staining technique looks for rabies antibodies rather than the rabies
virus itself because the antibodies indicate the immune response to the virus, which can
confirm the presence of the virus even if the viral load is low.
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

6
Conclusion
David's case underscores the challenges in diagnosing rabies in live patients, as no single test
is sufficient. The combination of clinical symptoms, laboratory tests, and careful evaluation is
crucial for accurate diagnosis and timely intervention to prevent the progression of rabies
infection. Ongoing monitoring and repeat testing may be necessary to ensure comprehensive
management and follow-up care for patients at risk of rabies exposure.

Clinical Focus 5:
Introduction
Anita is a 36-year-old mother of three who presented to an urgent care center with complaints
of pelvic pressure, frequent and painful urination, abdominal cramps, and occasional blood-
tinged urine. Suspecting a urinary tract infection (UTI), the physician initiated treatment with
ciprofloxacin pending urinalysis results.

Assessment
Signs and Symptoms
● Pelvic pressure
● Frequent and painful urination
● Abdominal cramps
● Occasional blood-tinged urine
Diagnosis
The physician suspected a secondary yeast infection caused by Candida albicans due to the
disruption of normal vaginal microbiota.

Planning
Anita was prescribed ciprofloxacin for her UTI. However, due to antimicrobial susceptibility
test results indicating ineffectiveness, a new antibiotic was chosen following confirmation of
the bacteria.

Implementation
Anita followed the treatment plan by using the antifungal medication as prescribed.

Evaluation
After treatment, Anita's symptoms of vaginal itching, burning, and discharge should improve,
indicating the successful elimination of the yeast infection. Follow-up appointments may be
scheduled to ensure resolution of the infection.

Conclusion
Anita's case underscores the importance of considering secondary infections following
antibiotic treatment, necessitating prompt diagnosis and appropriate management. She was
 Republic of the Philippines
NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY
College of Nursing and Applied Sciences
Brgy. Rizal, Sagay City, Negros Occidental
(034)722-4120, www.nonescost.edu.ph

7
prescribed an antifungal drug to address the yeast infection, leading to resolution of her
symptoms.