- In this case history, a 49 year-old man handled a parakeet with a respiratory illness on February 7. On March 9, he experienced intense pain in his legs, followed by severe chills and headaches. On March 16, he had chest pains, cough, and diarrhea, and his temperature was 40°C. Appropriate antibiotics were administered on March 17, and his fever subsided within 12 hours. He continued taking antibiotics for 14 days. Identify each period in the pattern of disease that he experienced. Note: The disease is psittacosis. Can you find the etiology?
- Mycobacterium avium-intracellulare is prevalent in AIDS patients. In an effort to determine the source of this infection, hospital water systems were sampled. The water contained chlorine. What is the usual method of transmission for Mycobacterium? What is the probable source of infection in hospitals? How can such nosocomial infections be prevented?
| Percentage of samples with M. avium |
| Hot water | Cold water |
| February | 88% | February | 22% |
| June | 50% | June | 11% |
- Twenty-one percent of the patients in a large hospital acquired Clostridium difficile diarrhea and colitis during their hospital stay. Epidemiological studies provided the following information. What is the most likely mode of transmission of this bacterium in hospitals? How can transmission be prevented?
| Rate of infection for patients: |
| Single room | 7% |
| Double room | 17% |
| Triple room | 26% |
| Rate of environmental isolations of C. difficile: |
| Bed rail | 10% |
| Commode | 1% |
| Floor | 18% |
| Call button | 6% |
| Toilet | 3% |
| Hands of hospital personnel after contact with patients that were culture-positive for C. difficile: |
| Used gloves | 0% |
| Did not use gloves | 59% |
| Had C. difficile before patient contact | 3% |
| Washed with nondisinfectant soap | 40% |
| Washed with disinfectant soap | 3% |
| Did not wash hands | 20% |
After you have solved the puzzles and uploaded your document, thoughtfully and objectively critique one case solution each from two of your peers (two critiques in total). If you find something your peer said to be interesting, then state specifically why. Are there alternative solutions to what your colleagues proposed? Be specific in your critique and provide the facts supporting your alternatives. Be sure to focus your critique on the facts presented and not on the person or anything in the response that may be interpreted as opinion.
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