For each of these try to determine the disease and the underlying pathogenic mechanisms responsible
Clicking the "diagnosis" button will give you the answer to the case and key identifying symptoms
CASE 1
The patient, a 28-year-old woman realized she was getting a cold when she noticed a scratchy feeling in the throat, sneezing, nasal discharge, low-grade fever, and malaise. The symptoms worsened, reaching a peak after 48 hours. Within several days, her nasal discharge thickened and was slightly yellowish, and then subsided over the next several days. All of her other symptoms resolved completely within about 7 days of onset. She thought that she acquired the illness from her 7-year-old child, who had had similar symptoms a few days earlier.
CASE 2
A 2-year-old child with fever for 2 days was crying often and not eating. Upon examination, the physician noted that the inside of the mouth was covered with numerous shallow pale ulcerations over the gums, tongue, and wall of the mouth. A few red papules and blisters were also observed around the border of the lips. The symptoms continued to worsen over the next 5 days and then slowly resolved with complete healing after 2 weeks.
CASE 3
A 25-year-old carpenter noticed the appearance of several hyperkeratotic papules (warts) on the palm side of his index finger. They did not change in size and caused him only minimal discomfort. After a year, they spontaneously disappeared.
CASE 4
A 28-year-old woman was admitted to the hospital complaining of vomiting, abdominal discomfort, nausea, anorexia, dark urine, and jaundice. She admits to having shared needles as a former heroin addict and is 3 months pregnant.
CASE 5
The patient, a 7-month-old girl, was recently switched from breast to bottle feeding. Usually a happy and satisfied child, she became irritable, began to vomit, and had a low-grade fever. The GI symptoms persisted for 2 days and she was brought to the pediatrician who made the diagnosis by detecting rotavirus antigen in the stool with an ELISA assay.
CASE 6
The patient, a 39-year-old white male with an 8-year history of intravenous heroin abuse presented in January of the previous year with esophageal candidiasis and was found to be HIV-1 antibody positive by western blot and ELISA. The patient was hospitalized in May of the previous year and in April with episodes of Pnuemocystic carinii pneumonia, which resolved after intravenous therapy with trimethoprim-sulfamethoxazole.
On June 6, after 1 week of progressive unproductive cough, dyspnea, fever, and a weight loss of approximately 3 kg, he was readmitted to the hospital. On examination, the patient was febrile, and was noted to have oropharyngeal candidiasis. Results of tests for HIV p24 antigen were positive. On June 28, the patient's level of consciousness deteriorated.
Intravenous antibiotics were continued for four weeks, but there was a gradual deterioration of the patient's level of consciousness. Repeated cultures of his blood, urine, and CSF remained sterile. He remained comatose with mild respiratory insufficiency. On August 3, the patient had respiratory arrest and died. Postmortem examination showed disseminated infection with cytomegalic inclusion bodies in brain and lung tissues.
CASE 7
On November 25, a beaver exhibited aggressive behavior by charging canoes and kayaks on the Ichetucknee River in Alachua County, Florida. The beaver was captured by park personnel and submitted to a Florida Department of Health (FDoH) laboratory for testing. Park rangers contacted the Alachua County Health Department after they identified five persons who were in the vicinity of the animal before capture. These five persons were interviewed by county health department personnel, who reported that although the beaver had made aggressive actions, the animal had not bitten anyone.
On November 27,
the FDoH laboratory diagnosed the disease in the brain tissue of the beaver
by using a fluorescent antibody test. Monoclonal antibody strain typing indicated
that the virus belonged to the antigenically distinct group of viruses found
in raccoons in the eastern United States. Park personnel involved in the capture
of the animal received postexposure prophylaxis. No treatment was recommended
for the five persons who had been in the vicinity.