case analysis 45 yo male presents to ER with arm pain and rash He is a Gardener Symptoms started 2 weeks ago after landscaping Denies spider/insect bite Lesions slowly tracking up right forearm, moving up above elbow Some of the lesions are beginning to rupture Patient was diagnosed with____Infection, but ER physician also wants to cover cellulitis.He was discharged with prescription for Itraconazole and Clindamycin. 10 days later……Patient returns to ER. Lesions are now “necrotic, raised, tender, ulcerated, located on the palmar aspect of right forearm and dorsal aspect of right forearm”. Patient is then admitted. It is discovered that patient only filled prescription for Clindamycin. He said he could not afford the Itraconazole prescription. Physician collected fluid from pustules and also performed punch biopsies. ‐ Both were sent to lab for aerobic, anaerobic, fungal, and AFB cultures. ‐ CBC ‐Fungal antibodies. Laboratory results: CBC: ◦WBC 11.8 H (4.0‐10.0 K/uL) ◦RBC 5.04 (4.10‐5.80 M/uL) ◦Hgb 15.9 (13.0‐17.5 g/dL) ◦HCT 45.8 (39.0‐52.0%); Differential: Neutrophils 71 H (32‐64%), Lymphocytes 14 L (25‐48%), Monocytes 6 (4‐6%), Eosinophils 8 (2‐3%), Basophils 1 (0‐1%). Fungal Antibodies: ◦Aspergillus spp. Ab- None detected ◦Blastomyces dermatitidis- Ab None detected ◦Coccidioides immitis Ab- None detected ◦Histoplasma spp.- Ab None detected Aerobic cultures- No growth Anaerobic cultures- No growth AFB cultures- No growth Fungal cultures- Positive; Mold growing after 5 days of incubation Surface: White periphery with black center, wrinkled LPCB: Rosette clusters Dimorphic mold: ◦Converted to yeast phase at 35°C ◦Fusiform budding cells, “cigar bodies” Patient was discharged improved after treatment with Itraconazole.
Microbial Physiology
Microbial physiology is the branch of microbiology that is associated with studying the physiology of fungi, bacteria, and viruses. It is an important field of science concerning functional genomics and metabolic engineering.
Chemotaxis
The organism’s movement in a particular direction as a response to certain chemicals that are available in the environment is defined as chemotaxis. In brief, it can be defined as the occurrence of an organism’s movement in response to a certain chemical stimulus.
case analysis
45 yo male presents to ER with arm pain and rash
He is a Gardener
Symptoms started 2 weeks ago after landscaping
Denies spider/insect bite
Lesions slowly tracking up right forearm, moving up above elbow
Some of the lesions are beginning to rupture
Patient was diagnosed with____Infection, but ER physician also wants to cover cellulitis.He was discharged with prescription for Itraconazole and Clindamycin.
10 days later……Patient returns to ER. Lesions are now “necrotic, raised, tender, ulcerated, located
on the palmar aspect of right forearm and dorsal aspect of right forearm”. Patient is then admitted.
It is discovered that patient only filled prescription for Clindamycin. He said he could not afford the
Itraconazole prescription.
Physician collected fluid from pustules and also performed punch biopsies. ‐ Both were sent to lab
for aerobic, anaerobic, fungal, and AFB cultures. ‐ CBC ‐Fungal antibodies.
Laboratory results:
CBC: ◦WBC 11.8 H (4.0‐10.0 K/uL) ◦RBC 5.04 (4.10‐5.80 M/uL) ◦Hgb 15.9 (13.0‐17.5 g/dL) ◦HCT 45.8
(39.0‐52.0%); Differential: Neutrophils 71 H (32‐64%), Lymphocytes 14 L (25‐48%), Monocytes 6
(4‐6%), Eosinophils 8 (2‐3%), Basophils 1 (0‐1%).
Fungal Antibodies:
◦Aspergillus spp. Ab- None detected
◦Blastomyces dermatitidis- Ab None detected
◦Coccidioides immitis Ab- None detected
◦Histoplasma spp.- Ab None detected
Aerobic cultures- No growth
Anaerobic cultures- No growth
AFB cultures- No growth
Fungal cultures- Positive; Mold growing after 5 days of incubation
Surface: White periphery with black center, wrinkled
LPCB: Rosette clusters
Dimorphic mold:
◦Converted to yeast phase at 35°C
◦Fusiform budding cells, “cigar bodies”
Patient was discharged improved after treatment with Itraconazole.
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