Case Study 1

1997 by D'Maris Allen

A 23-year old female walks into a medical clinic in Austin complaining of an erythematous maculopapular rash, malaise, and fever of two days duration. She also reports a headache, sore throat and mild cough, but denies any gastrointestinal symptoms.

Upon examination, she has a temperature of 38.5 C, blood pressure of 100/62 mm Hg, pulse rate of 110 beats per minute, and a respiratory rate of 38/minute. She also reports malaise, swollen lymph nodes, and recent patchy hair loss. The doctor checks her buccal mucosa for Koplik's spots and asks about any recent history of tick bites. He also inquires about her MMR vaccination status and whether she might be pregnant. A throat culture is ordered and blood is drawn for serological testing.

1. What bacterial/viral diseases does the doctor suspect and WHY? (Give your differential diagnosis of about 5 diseases.)

2. What is the doctor ruling out by looking for buccal mucosa lesions?

             Serology ordered includes RPR and Weil-Felix. What diseases will these tests diagnose?

3. The throat culture is reported negative for hemolytic Group A Strep. The disease is diagnosed serologically by a positive RPR and confirmed with a TPPA.

4. What disease and stage of the disease is this?

             What specific risks can this pose to a fetus?

             Describe the usual symptoms seen at other stages of this disease and what the outcome might be without treatment.

5. How common is this disease in the world; in the U.S.? (use RECENT incidence/prevalence figures for each)

           Describe all ways it can be transmitted.

           Describe control methods for this disease at personal, national and international levels.  BE SPECIFIC!!


Don't forget to properly submit your minimum of five references endnoted with your answers!