Friday, January 2, 2009

Par 3

All of the three following cases have the same gram stain above. Note that the organisms are curved.

Challenge 1: A 40 year old man presents with burning epigastric pain worst 2-5 hours after food and also at night. What's the organism?

Challenge 2: A 40 year old man presents with cramping periumbilical abdominal pain and profuse diarrhea and frank blood seen in the stool. He also has nausea and fever. The diarrhea is self-limiting, lasting about a week. What's the organism?

Challenge 3: A 40 year old traveler to Africa develops massive watery diarrhea, described as watery with flecks of mucus. There is a mild "fishy" odor. He also experiences watery vomiting, abdominal cramping but no pain, and no fever. What's the organism?

Image shown under fair use.


CodeDog said...

The image shown is a culture of of the gram negative Campylobacter jejuni organism.
This is a common cause of diarrhea, abdominal pain and bloody stool.
It is usually contracted from eating undercooked meats or contact with infected animals/people (or their fecal matter).
Commonly referred to as traveler's diarrhea.

Here in California, when returning from a trip to Mexico we call it Montezuma's revenge.

Stephanie said...

1 - helicobacter pylori
2 - vibrio vulnificus
3 - vibrio cholera

Craig Chen said...

Par 3

The human pathogenic curved gram-negative rods are Helicobacter pylori causing duodenal peptic ulcer disease (1), Campylobacter jejuni or C. coli causing enteritis (2), and Vibrio species (V. cholerae with rice water stools in 3).

Sources: UpToDate;

Alex said...

oh, thought it was the exact same organism in all 3 cases..

when imagining c jejuni, i took the "seagull's wings" thing a little too literally.