Ch. 23 - Microbial Diseases of the Cardiovascular and Lymphatic Systems

Tortora - Microbiology: An Introduction 14th Edition

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Tortora 14th Edition

Ch. 23 - Microbial Diseases of the Cardiovascular and Lymphatic Systems

Problem 2

Chapter 23, Problem 2

Use the following choices to answer the question given below:
a. Ehrlichiosis
b. Lyme disease
c. Septic shock
d. Toxoplasmosis
e. Viral hemorrhagic fever
A patient was hospitalized because of continuing fever and progression of symptoms including headache, fatigue, and back pain. Tests for antibodies to B. burgdorferi were negative. What is your diagnosis?

Verified step by step guidance

Step 1: Identify the key symptoms presented by the patient: continuing fever, headache, fatigue, and back pain. These symptoms are common in several infectious diseases, so careful consideration is needed.

Step 2: Note that tests for antibodies to B. burgdorferi were negative. Since B. burgdorferi is the causative agent of Lyme disease, a negative antibody test suggests Lyme disease is unlikely.

Step 3: Review the list of possible diagnoses and their typical clinical features: a) ehrlichiosis often presents with fever, headache, fatigue, and muscle or back pain; b) Lyme disease is ruled out by the negative antibody test; c) septic shock involves severe systemic infection with hypotension and organ failure; d) toxoplasmosis usually involves flu-like symptoms or is asymptomatic; e) viral hemorrhagic fever includes bleeding and severe systemic symptoms.

Step 4: Based on the symptoms and negative Lyme disease test, consider ehrlichiosis as the most likely diagnosis because it matches the symptom profile and is caused by bacteria transmitted by ticks, similar to Lyme disease but distinct in diagnosis.

Step 5: Conclude that the diagnosis is ehrlichiosis, supported by the clinical presentation and exclusion of Lyme disease through antibody testing.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Borrelia burgdorferi and Lyme Disease

Borrelia burgdorferi is the bacterium that causes Lyme disease, typically transmitted by tick bites. Diagnosis often involves detecting antibodies against B. burgdorferi, but early testing can be negative. Understanding this helps differentiate Lyme disease from other illnesses with similar symptoms.

Differential Diagnosis in Infectious Diseases

Differential diagnosis involves distinguishing a disease from others with overlapping symptoms by considering clinical presentation and test results. Negative antibody tests for B. burgdorferi suggest ruling out Lyme disease and considering other infections like ehrlichiosis or toxoplasmosis.

Ehrlichiosis and Its Clinical Features

Ehrlichiosis is a tick-borne bacterial infection causing fever, headache, fatigue, and muscle pain, similar to Lyme disease. It often lacks specific antibody tests early on, making clinical suspicion important. Recognizing its symptoms aids in accurate diagnosis when Lyme disease tests are negative.

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Textbook Question

Use the following choices to answer the question given below:

a. Ehrlichiosis

b. Lyme disease

c. Septic shock

d. Toxoplasmosis

e. Viral hemorrhagic fever

A patient complained of headache. A CT (computed tomography) scan revealed cysts of varying size in the patient’s brain. What is your diagnosis?

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Textbook Question

Compare and contrast epidemic typhus, endemic murine typhus, and tickborne typhus.

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Textbook Question

Use the following choices to answer the question given below:

a. Ehrlichiosis

b. Lyme disease

c. Septic shock

d. Toxoplasmosis

e. Viral hemorrhagic fever

A patient presents with a history of fever and headache. Bacterial cultures of blood, CSF, and stool are negative. What is your diagnosis?

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Textbook Question

Complete the following table.

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Textbook Question

Show the path of Streptococcus from a focal infection to the pericardium. Identify the portals of entry for T. cruzi, Orthohantavirus, and Cytomegalovirus.

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