Star Team

MMIC PBL 1 (Case 4)
Name: Tong Wei Hong
Sex: Male
Age: 68 years old

Complaints: Fever, chills, excessive phlegm, breathing problems
Diagnosis: Bronchitis

Bronchitis is inflammation of the large airways that branch off the trachea (bronchi), There are 2 types of bronchitis; acute and chronic. Acute bronchitis is usually caused by viral or bacterial infection, while chronic bronchitis is caused by irritation from a gas or particle.

Some symptoms include fever with chills, muscle aches, nasal congestion, breathing difficulties and sore throat.

Mycoplasma pneumoniae and Chlamydia pneumoniae often cause bacterial bronchitis in young adults. Among middle-aged and older people, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms causing bacterial bronchitis.

Possible bacteria that cause bronchitis and laboratory diagnosis to identify:

Mycoplasma pneumoniae

• Cannot be identified by Gram-staining due to the lack of cell wall
• Serologic testing is recommended. A cold-agglutinin titer of 1:128 or higher is indicative of recent infection.

Chlamydia pneumoniae

• Gram-negative; possess rigid cell wall
• Serologic testing is recommended. A four-fold rise in IgG or IgA antibody titer between paired sera is indicative of infection

Streptococcus pneumoniae

• Gram-positive diplococci
• Seen as alpha-hemolytic colonies on blood agar
• Growth inhibited by bile and optochin
• Quellung reaction occurs (capsular swelling in the presence of antisera)

Haemophilus influenzae

• Gram-negative rod
• Culture on chocolate agar (growth requires factors X[heme] and V[NAD]

Moraxella Catarrhalis

• Gram-negative coccobacillus rod
• Produce beta-lactamase (i.e. resistant to beta-lactam antibiotics such as penicillin, cephalosporins, etc.)

References

http://www.merck.com > search: bronchitis > Lung and Airway Disorders

http://www.pulmonologychannel.com > search: bronchitis> Acute bronchitis – pulmonologychannel

Levinson, W. (2006). Review of Medical Microbiology & Immunology. San Francisco, California: Lange Medical Books/McGraw-Hill publishing company

Martin Ng

TG02

0503312A

# posted by Star team @ 10:21 PM