Case 1

A 10 year old boy was examined in the hospital with conditions of fever and painful red and swollen joints.Two weeks earlier he had developed a severe sore throat infection which showed gram positive cocci in chains

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Case 1.Describe the morphology of

the organism below.Gram positive cocci in

chains

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Case 1Mention the effect of the disease on the organ belowA.Cross reacting streptococcal antibodies against the heartcan lead to pericarditis,myocarditis etc

.

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Case1.1.What is your provisional diagnosis?A.Rheumatic fever

2.What is the primary infection in this case?A.streptococcal sore throat

3.What other complications can rise by the primary infection?A.Acute glomeronephritis

4.What further lab tests can be done to confirm the secondary condition?A.ASO(measurement of antisreptolysin antibody titre is important in investigation of post streptococcal disease

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Case 1.What is the possible clinical picture below?A.Rare complication of rheumatic fever leads to rheumatic nodules on the elbow seen below

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Case 2A young girl was examined in hospital with a fever of 101F and chills.A tiny rash was observed on the chest and the stomach.She also had a whitish coating on the surface of the tongue and it gave the appearance of strawberry shape

.…

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Case 2.What can be the most likely disease?A.Scarlet fever

Did she develop an earlier disease?AStreptococcal pharyngitis(organism releases pyrogenic toxin)

Is the rash contagious?A.No-Develops 2 days after pharnygitis till about 7 days

Does the child develop permanent immunity?Yes-for this disease

.

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Case 2Describe the media,the

reaction and the possible organism below

Blood agar plate showing Complete heamolysis around

colonies(B-hemolysis)

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Case 2What are the complications of the clinical picture below?The throat swab showed gram positive cocci in chainsA.Rheumatic fever,acure glomerulonephritis

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Case 3

Four hours after eating a cake ,a group of students developed a sudden attack of acute diarrhoea,

vomiting, and abdomainal cramps.

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Case 3

1.What is your provisional diagnosis?

Food poisoning2.What is the factor involved

in causing the disease?Stapylococcus areus toxin

3Can the causative agent be destroyed by normal cooking

procedures?A.yes to the organism no to the toxin

4.What is the difference between food borne disease

and food poisoning?A.Different concepts

1.Cross contamination or improper cooking

2.Multiplication of bacteria in the food

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Case 3.Describe the morphology of

the microorganism belowA.gram positive cocci in

clusters(groups)

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Case 4

A menstruating woman using tampons presented herself to a clinic with symptoms of sudden high fever,hypotension,and a rash like sunburn on her palms and soles.

Gram stain of cervical samples showed gram positive cocci in clusters

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1.What is your provisional diagnosis?A.Toxic shock syndrome

2.What is the risk factor involved in this case?A.Tampons.May have high levels of toxigenic stapylococci

3.Name complications of the disease.A.involves central nervous system,gastrointestinal hepatic, renal,failure(

Case 4

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Case 12A male patient was

examined in the clinic for dysuria.On examination he had some urethral

discharge.A Gram stain was performed on the

discharge.

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This direct smear is from a urethral discharge on a male; how would you report it out?

A.Direct smear showing extracellular gram negative diplocooci(you will proceed with further lab tests

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What is the selective plate that can be used for isolation of Neisseria gonorrhoeae &

Neisseria meningitidis?.Thayer-Martin media

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What would be the expected oxidase test result if the organism is a Neisseria .A.oxidase positive

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The presence of gram negative diplococci intracellularly and extracellularly is

diagnostic in acute male -urethritis

.

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Case 12

•What complications can this untreated condition in females

progress to?•Chocolate agar

•A.sapingitis pelvic inflammatory disease(PID) are some examples

•.

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Case 13

•A patient with symptoms of a fever, headache, and stiff neck which took two days to develop came to the clinic.

•Other symptoms were nausea and vomiting, sensitivity to lights, drowsiness, confusion,

and sleepiness .• A more serious

complication had developed.

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Case 13•1.What is your provisional

diagnosis?•Meningitis

•2.Should antibiotics be given immediately on suspicion of

the case?•Yes

•3.How is the infection spread?•Droplet infection-leading to

meningitis or meningoceamia•4.What precaution is taken

while performing Haj?•A.immediate isolation with

antibiotic therapy

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Carbohydrate tests•Which member of this

genus gives GLUcose + and MALtose?-

•A.Neisseria meningitis

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Case 13

•What is this clinical condition called

•Large heamorrhagic skin lesions leading to Water-house friederichsen syndrome

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Case 14

•A patient was admitted to the clinic with complaints of sore throat,fever,and headache.Clinical examanation showed a formation of a psuedomembrane on the tonsils.

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Case 14•1.What is your provisional

diagnosis?

•Suspected case of diphtheria

•2.How is the disease spread?

•By asynptomatic carriers through droplet infection.

•Skin contact for cutaneous diphtheria

•3.Name the vaccine for the disease.

•Diphtheria toxoid given in childhood as DPT in combination with polio and tetanus

•4.What are volutin or metachromatic granules?

•Energy releasing cont phosphatase

Case 14

What is the name of this stain and what is it used for?

A.Alberts stain to show the presence of volutin granules

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Case 14Bull neck appearance is a complication of diptheria

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Case 14

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Case 14

•Name the stain and the arrangement of the organism.

•A.gram stain showing gram positive bacilli with chinese letter arrangement

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Case 14

•Which is the most serious type of diphtheria strain?

•A. C.diphtheria gravis

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Case 14

•Name and describe this medium.

•A.Loefflers serum slant agar is an enriched medium for growth of C.diphtheria can show metachromatic granules

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Case 14

Name the testWhat is the reaction called.

A.this is an Elek test .Double diffusion reaction between toxin and antitoxin to test the presence of toxin producing C. diptheria

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Case A

•A 48 year old patient was examined at the clinic after showing symptoms of crampy abdominal pain,nausea,vomiting ,diarrhoea and fever.

•There was no blood in the stool•He had not eaten any raw or

unprocessed food except for eggs at a friends place one day earlier.

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Case A

•What is your provisional diagnosis?

•Salmonella food poisoning

Name a common bacterial agent that causes this conditionSalmonella typhi

•What are the most common sources of human infection

with this organism?•Poultry,eggsdairy

productsfoods on contaminated work surfaces

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Case AXLD agar with black colonies

Flagellar stain showing petrichous flagella

Gram stain showing Gram negative bacilli

TSI slant showing H2S production

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Case B

•A young woman was examined in the clinic showing symptoms of dysuria, frequency during micturation and suprapubic pain.

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Case B

•1.What is your provisional diagnosis?

•Urinary tract infectionA.

•2.What is the possible causative agent, if it showed

•A.Indole test positive?•Probably E.coli if it shows

lactose fermentation on Macconkeys agar

•3.What is the most likely mechanism by which this

organism infects the urinary tract?

•A.Originate in the colon,contaminate

urethra ,ascend into the bladder

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Case B

•Are Gram negative

•Motile •Some are

capsulated•Facultative

anearobes

E.coli Gram stain

E.coli on blood agar

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Case B

E.Coli in GIT

Indole positive in right tube

EMB agar showing green metalic colonies

Pink lactose fermenting colonies

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Case C

•A patient with renal colic was admitted to the hospital.

•He was diagnosed as having pyelonephritis (UTI infection)

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Case CBiochemical tests first row proteus-

API

Swarming of Proteus species on blood agar

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Case C

•Urease positive test

•left tube

•Antimicrobial sentivity tests to detect urinary pathogens

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Case C

•1.What could the possible causative organism be?

•Proteus

•2.Name two laboratory characteristics of this organism

•Swarming on Nutrient agar,positive urease test

•Describe the morphology of this bacteria

•Gram negative,highly pleomorphic,actively motile and non-capsulatedBalgees Almaeena

Case CNon-lactose fermenting colonies on

right

Swarming on blood agar

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Case C

•Proteus vulgaris Gram stain

•Proteus flagella

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Case D

•A child at the nursery school was admitted to the clinic.

•Her symptoms were abdominal cramps ,fever, and diarrhoea

• Stool examination revealed pus ,blood and mucus

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Case D•1.What is your provisional

diagnosis?

•Dysentery bacillary

•2.State the virulence factors of the organism causing this disease.

•.Endotoxin and genes(adherence ,invasion,intracellular replication.Shiga toxin disrupts protein synthesis and produces endothelial damage.

•3.Describe its growth on MacConkeys agar

•Non-lactose fermenters

•4.State the differences between diseases caused by S.typhi and S.sonnei

Case D

•XLD agar showing no H2S production

•Shigella on MacConkeys agar-non lactose fermenting colonies

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Some laboratory culture picturesKliebsiella

pneumoniae on Macconkeys

TCBS agar for Vibrio cholera

.Pyocin pigment on

nutrient agar P.aeroginosa

Salmonella on salmonella shigella

agar

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