A 17-year-old patient went to the dentist 2 weeks ago and ha…

A 17-year-old patient went to the dentist 2 weeks ago and had all 4 wisdom teeth extracted. She felt worse than you do taking this test. Now she presents with continuing jaw pain and a low-grade fever (temperature of 100 degrees). Her mother tells her that her breath smells really bad now. A list of organisms that would most likely cause this scenario would be:

Case Study 2:  This 63-year-old alcoholic was taken to the e…

Case Study 2:  This 63-year-old alcoholic was taken to the emergency room of an outside hospital with obvious gangrene of both feet.  He was stuporous.  During that evening, he had a seizure and was treated with phenytoin and barbiturates.  By the night of transfer he was noted to have opisthotonic posturing and to have developed increasing respiratory distress and unresponsiveness.  On examination, he had a temperature of 41.7°C rectally, a blood pressure of 70/30 mmHg, a heart rate of 110 beats/min, and a respiratory rate of 40/min.  Examination was notable for marked trismus.  The neck was stiff and hyperextended.  Necrotic, blackened areas were present over both feet and several draining ulcers were noted on the heels and toes.  Neurologically the patient responded to deep pain with a grimace.  On the basis of these findings, specific therapy, in addition to supportive care, was initiated, and the patient ultimately recovered. Case Study 2.1:  What organism is most likely causing the infection which occurred secondarily to the gangrene?

Case Study 3: A 3-year old girl presents at the emergency ro…

Case Study 3: A 3-year old girl presents at the emergency room with bloody diarrhea, fever and vomiting. The child’s mother reports that the day-care center called yesterday morning because she started having a watery diffuse diarrhea.  That night she began to complain of severe cramps and her diarrhea became bloody and pus-filled.  The family has no recent travel history and while they are vegetarians, they only consume pasteurized milk, cheese, and egg products.  The gram stain showed many white blood cells and many gram-negative bacilli.  The culture resulted in many yellowish-clear colonies on the MacConkey’s agar that were oxidase negative and fermented glucose.   She was admitted to the hospital to treat her dehydration and for observation.  Case Study 3 Question 3:  Which of the following characteristics is inconsistent with the isolated organisms?