13.2: Lab Report for Case Study #1

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Your Name:

Others in your group:

Unknown number (1-6):

Lab section:

Date:

Case Study #1A from Lab 12

A 26-year old female presents to her doctor complaining of 2 days of increased urinary frequency, dysuria, and sensation of incomplete voiding. Her abdominal exam indicates mild suprapubic tenderness. Her blood pressure is normal and she does not have fever, chills, costovertebral angle (CVA) tenderness, or vaginal discharge. She reports that she became sexually active with her new boyfriend one month ago. She and her boyfriend have sexual intercourse 3-4 times a week. She is using a combination of a diaphragm and spermicide for contraception. She is otherwise healthy. A microscopic examination of her centrifuged urine shows 9 white blood cells and 15 bacteria per high-power microscopic field. A urine dipstick shows a positive leukocyte esterase test and a positive nitrite test.

Assume that your unknown is from the urine of this patient.

Case Study #1B from Lab 12

A 90-year old woman resides at an area nursing home. She shows signs of mild dementia, and because of severe arthritis and requiring a walker for ambulation, sits in a chair most of the day. She has not used any form of estrogen in at least 30 years. She also has a history of 4-5 confirmed urinary tract infections per year. This morning, her caregiver is unable to coax the patient out of her bed. She seems confused and disoriented. Vital signs reveal tachycardia in the 120â€™s, respirations at 24 per min, and a blood pressure of 78/49. She is immediately taken to an ER for evaluation. A CT of the abdomen and a chest x-ray appear normal. She has a WBC count of 2300/µL. She continues to exhibit marked confusion compared to her baseline and is exhibiting anxiety. Urine and blood samples are taken and sent for culture and sensitivity.
Assume your unknown is from both a urine sample and a blood sample.

Case Study #1C from Lab 12

A 79-year old man living in a nursing home has COPD, a lifetime history of heavy smoking, and hypertension. His caregivers note that he is exhibiting rigor, has a temperature of 103°F, and lacks his normal alertness. Vital signs include a blood pressure is 165/90, a pulse of 128 beats per minute, a respiratory rate of 32 breaths per minute, and a pulse oximetry on room air of 80%. He is transferred to an acute care facility where a chest X-ray reveals a right lower lobe infiltrate, and his white blood cell count is 18,000/μL with a marked left shift. He has thick, foul-smelling yellow-green sputum.

Assume you unknown is from the sputum sample.

Did you have Case Study 1A, 1B, or 1C?______

1. Patient’s history and predisposing factors

Read the case study. Explain how any relevant parts of the patient’s history contributed to your diagnosis of the type of infectious disease that is present here. The patient's history refers to anything given in the case study prior to that patient seeking medical attention for the current medical condition. You are urged to use the computers in lab to search reliable medically oriented Internet sources to support this. Reliable sources you might consider are Medscape (http://emedicine.medscape.com/infectious_diseases) and The Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/. Cite any sources you use at the end of this Patient's History section in APA style (https://www.scribbr.com/apa-examples/website/).

The patient's history should suggest a general type of infectious disease that is present, such as a urinary tract infection, a wound infection, gastroenteritis, pharyngitis, pneumonia, septicemia, etc. Do not look up the bacterium you eventually identify as the cause of this infectious disease. You do not know the causative bacterium at this point. You need to determine the general type of infection in order to determine what microbiological tests to perform to identify the bacterium causing the infection. Search at least one medically oriented reference article from a reliable site such as Medscape and use this article to support your diagnosis of the type of infectious disease seen here. Don't forget to cite any sources you used in APA style directly under this Patient's History and Patient's Symptoms sections of this Lab Report.

2. Patient’s signs and symptoms

Read the case study. Explain how the patient’s signs and symptoms contributed to your diagnosis of the type of infectious disease that is present here. Signs refer to anything being measured by a medical professional during a physical exam such as blood pressure, respiration rate, heart rate, oxygen saturation, and temperature. Symptoms refer to symptoms being reported by the patient. You are urged to use the computers in lab to search reliable medically oriented Internet sources to support this. Reliable sources you might consider are Medscape (http://emedicine.medscape.com/infectious_diseases) and The Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/. Cite any sources you use at the end of this Patient's Symptoms section in APA style (https://www.scribbr.com/apa-examples/website/). Also see appendix F (SIRS and Sepsis) in your lab manual for an indication of whether or not the patient has SIRS.

The patient's signs and symptoms should suggest a general type of infectious disease that is present, such as a urinary tract infection, a wound infection, gastroenteritis, pharyngitis, pneumonia, septicemia, etc. Do not look up the bacterium you eventually identify as the cause of this infectious disease. You do not know the causative bacterium at this point. You need to determine the general type of infection in order to determine what microbiological tests to perform to identify the bacterium causing the infection. Search at least one medically oriented reference article from a reliable site such as Medscape and use this article to support your diagnosis of the type of infectious disease seen here. Don't forget to cite any sources you used in APA style directly under this Patient's History and Patient's Symptoms sections of this Lab Report.

3. Vocabulary list for medical terms used in the case study under signs and symptoms

List and define any medical terms used in your case study that describe the patients’s signs and symptoms that the average person not in the medical profession might not know.

4. Results of laboratory test given in the case study

List each lab test given in the case study that are done in a lab, such as total white blood count, differential white blood cell count, urinalysis, and X-ray, and explain how the results of that test helps to contribute to your diagnosis. Refer to appendix C (Complete Blood Count), and appendix D (Urinalysis).

5. Microbiological lab tests you performed in Lab 12

a. Gram stain

Give the Gram reaction (Gram-positive or Gram negative and how you reached this conclusion) and the shape and arrangement of the unknown you were given. State how these Gram stain results contributed to your decision of what microbiological test to perform next. The Gram stain is discussed in Lab 6.

b. Oxidase test

Give the results of the oxidase test (positive or negative) you performed on the unknown you were given, and how you reached this conclusion. State how the oxidase test results contributed to your decision as to what microbiological media to use next. The oxidase test is discussed in Lab 12 under C. Lab Tests Used in Today’s Lab.

c. MacConkey agar (if used)

Describe the results of the MacConkey agar plate you inoculated with the unknown you were given. State how this contributed to narrowing down your identification of the bacterium causing the infectious disease. MacConkey agar is discussed in Lab 12 under C. Lab Tests Used in Today’s Lab.

d. Cetrimide agar (if used)

Describe the results of the Cetrimide agar plate you inoculated with the unknown you were given. State how this contributed to your identification of the bacterium causing the infectious disease. Cetrimide agar is discussed in Lab 12 under C. Lab Tests Used in Today’s Lab.

e. EnteroPluri-Test.

Using your EnteroPluri-Test, identify the unknown you were given. TheEnteroPluri-Test and its use are described in Lab 12 under C. Lab Tests Used in Today’s Lab.

1. In the table below, put a (+) or a (-) in the Result row for each test.
2. Add up the value of each positive test in a group and put that number in the code for each group.
3. The 5 digit number is the CODICE number. Look that number up in the Codebook and identify your unknown.

	Group 1			Group 2			Group 3			Group 4			Group 5
Test	Glucose	Gas	Lysine	Ornithine	H2S	Indole	Adonitol	Lactose	Arabinose	Sorbitol	VP	Dulcitol	PA	Urea	Citrate
Value	4	2	1	4	2	1	4	2	1	4	2	1	4	2	1
Result
Code
CODICE NUMBER:

Genus and species of the bacterium: ________________________________

Final diagnosis:

What infectious disease does the patient have?

What is the genus and species of the bacterium causing this infectious disease?

Contributors and Attributions

Dr. Gary Kaiser (COMMUNITY COLLEGE OF BALTIMORE COUNTY, CATONSVILLE CAMPUS)