Microbiology Lab
Case study # 5
November 1,2012
1. What evidence suggests that the young graduate student has contracted what disease?
Ans: The signs and symptoms the young graduate student presented, show evidence of Lyme disease.
2. What is the environmental pathway for the vector of this disease?
Ans: The environmental pathway for the vector of this disease would be a forested habitat. The black-legged tick or the deer tick is the principle vector of this disease (Lyme disease), and they’re always found in forested habitat like the Pinelands. They actively transmit the pathogen from an infected reservoir host animal to another individual.
3. How did the student come in contact with this organism?
Ans: The student came in contact with this organism during her deer population study and walking miles through the Pinelands; which is a forested habitat and the home to deers.Ticks from these deer usually attaches to the clothes and later travel onto the skin.
4. What is the blood test that would confirm the presence of this pathogen in the student’s blood?
Ans: The blood test that would confirm the presence of this pathogen in the student’s blood stream would be an enzyme immunoassay (EIA) or Immonofluorescent assay (IFA) .Specimens yielding positive or equivocal results should be tested further by using a standardized western blot assay. Specimens that are negative by a sensitive EIA or IFA do not need further testing.
5: What are the characteristics of this pathogen.(Morphology,biochemistry,and pathogenicity).How do the possible pathogens in the case study differ?
Ans: Borrelia burgdorferi is a spirochete. Spirochetes are a group of phylogenetically-distinct bacteria that have a unique mode of motility by means of axial filaments. (endoflagella).Spirochetes are widespread in viscous environment, they also have a unique cell surface which accompanies their unique type of mortility.The endoflagella are contained within the periplasmic space between a semi rigid peptidoglycan helix and a multi layer, flexible outer membrane sheath.Borrelia bacteria has a fewer coils then other bacteria and average 0.2-0.5um by 4 to 8 um. When the filaments rotate within this space, the spirochetes move in clock-screw fashion. This type of movement is thought to be an adaptation to viscous environments, such as aquatic sediments, bioflims, mucosal, tissues and the intestinal tracts of animals .For pathogens, this allows the spirochetes to hide their flagella, which are normally antigenic, from the host immune defenses. Spirochetes are much longer than they are wide, and often their width is below the resolving power of the light.Hence,most spirochetes cannot be viewed using conventional light microscope .Dark field microscope must be used to view spirochetes.
Borrelia burgdorferi also has a three layer cell wall, helping to determine the spiral shape of the spirochete. This distinctive cell wall resembles those of Gram- negative bacteria.Bb is one of the most immune-suppressive infectious agents, affecting cellular immunity, humoral immnnity, and natural killer (NK) cell population. A person infected by Bb can remained asymptomatic for a long period of time and then suddenly, without warning, begin to experience symptoms once again. One of these mechanisms involves the invasion of tissues by the spirochete. The tip of the organism has the ability to bind to cells, spin and twirl until it stimulates the cells own enzymes to digest a part of the membrane, finally allowing entry. Once inside, the spirochetes results in either the death of the cell or takes up residency within. It may lie dormant for years, protected from both the immune system and the actions of antibiotics.Borrelia burgdorferi invades the blood and tissues of various infected mammals and birds. The natural reservoir for Bb is thought to be the footed mouse. Ticks transfer the spirochetes to the white –tailed deer, humans, and other warm-blooded animals after a blood meal on an infected animal. In humans, dogs, and many other animals, infection with Borrelia burgdorferi results in the pathology of Lyme disease. There’s not much of a difference in the possible pathogens of the case study in that the student presented her symptoms a week after her trip to the Pinelands and definition of the Lyme disease shows proves that a person can remained asymptomatic for a period of time before becoming symptomatic.
6: The patient’s constellation of symptoms suggests what course of antibiotic therapy?
Ans: Early symptoms will be treated with oral agents such as doxycycline, amoxicillin, or cefuroxime which are usually prescribed for 2-3 weeks. Later stage may require intravenous therapy, usually ceftriaxone or penicillin, is used for 2-3 weeks.
7: How should this treatment be followed up to prevent serious and continuing health problems? Ans: Treatment of Lyme disease should be followed up with specialists such as a Rheumatologist, Neurologist and Cardiologist to ensure that other disease/diseases are not the cause of unusual and prolonged presenting symptoms. References http://www.lymediseasereview.com/lyme-disease-treatment/ http://www.townsendletter.com/febmar2006/lyme0206.htm http://www.lymediseaseguide.org/lyme-disease-morphology
References: http://www.lymediseasereview.com/lyme-disease-treatment/ http://www.townsendletter.com/febmar2006/lyme0206.htm http://www.lymediseaseguide.org/lyme-disease-morphology
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