Case Report “Cooties”

1. Case Report“Cooties” Aldair Cabra Ryan Howe Kiana Smith Keishmari Vega

2. Patient- Daniel Stevens • 21 year old, Caucasian male reports symptoms of fever, chills, and sweating profusely and an inflammation of the stomach. He also reports having nausea and diarrhea. • Patient reports noticing symptoms for a week, but thought that it was a common flu.

3. Daniel Stevens • A college student at Ohio State University majoring in Journalism. • Reported that he recently lost his mother to Breast Cancer.

4. Exam at Local Hospital • Patient was seen by Physician Assistant • History and had physical exam • Medical history: Jaundice, has herpes (prescribed antiviral tablets to reduce outbreak) • Family history: No record of family history • Allergies: bees and amoxicillin • Patient Medication-Pseudoephedrine

5. Physician Assistant (PA) • Practice medicine under the supervision of a physiscian • Work in inner city clinics • Medicine doctor

6. Exam • Vital Signs • Ht 77” Wt 186 T-98.9°F, P-86, R-19 • HEENT: Autraumatic, Pupils are equal • CN Exam: WNL • Palpation shows minor inflated spleen • Normal Reflexes • Muscle Strength in lower/upper extremities, graded as +3 bilaterally • Normal lung sound • Heart Sound: Murmur detected

7. Exam (cont) • Abdominal exam shows pain, hernia detected • Diagnosis (DX)- Viral Gastroenteritis • Treatment (RX)- Check up with doctor weekly and get blood work done

8. Patient in Crisis • Patient has diarrhea, panic attacks, vision disturbances and depression • Other disturbing symptoms are vivid dreams, nausea, and headaches. • Sent to the doctor after 2 weeks of these constant symptoms

9. Patient is admitted to Hospital • Normal vital signs • Pulse ox is at 95% • Physician asks about traveling • Daniel says he went on a trip to South Africa a few months ago • Lab tests are admitted

10. Attending Hospital Physician • Doctor of Medicine MD • Doctor of Epidemiology EO • Specializes in detecting diseases

11. Getting the patient stabilized • Several tests taken • ECG- normal results • Physical/Neuro exam results WNL • Complete blood count, HIV, Urine Sample • Since he traveled he also got a parasite test

12. Lab Results • Plasmodium in the blood • RBC 4.3M cells/mcL • White blood cells 5K cells/mcL

13. Plasmodium Infection http://upload.wikimedia.org/wikipedia/commons/thumb/0/02/Mature_Plasmodium_malariae_schizont_PHIL_2715_lores.jpg/240px-Mature_Plasmodium_malariae_schizont_PHIL_2715_lores.jpg

14. Infectious Disease Specialist (ID) An ID diagnoses and treats infectious diseases. An ID is an internal medical doctor, they use specialized tests to diagnose reoccurring infections. Antibiotics are also prescribed by an ID or an arrange for vaccination. They are contacted when there is a risk in traveling to hazardous infectious areas.

15. Artesunate • Artesunate is a type of plant, belongs to category of antiprotozoal agents drugs. • Artesunate acts rapidly, stopping parasite development and preventing subsequent cytoadherence and rosetting

16. The Goal of Treatment • Cure the disease by getting rid of all the parasites. • Make a vaccine (shot) for this disease. • Patients that plan to go to this country must get a shot before going.

17. Malaria • Ronald Ross discovered mosquitoes transmitted malaria (1889) • An infectious blood disease that is caused by an infected Anopheles mosquito • Transmitted from one human to another • The parasite in Malaria (plasmodium) attacks the red blood cells

18. More about Malaria • This disease killed 655 thousand people in 2010 • 91% of those 655 are young children from Africa. • Curable

19. http://upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Anopheles_stephensi.jpeg/300px-Anopheles_stephensi.jpeghttp://upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Anopheles_stephensi.jpeg/300px-Anopheles_stephensi.jpeg Anopheles Mosquito

20. Disease Transmission • Only transmitted from mosquito to human • Mosquito makes a cycle and infects anyone that comes into its path.

21. Controlling the Disease • Disease is more controlled now, than it was before • Adults traveling into a very infected area are advised to take a antimalarials prophylactically (shot to prevent infection) • Use insecticides, to prevent bites from mosquitoes in general

22. Daniel Stevens • Spent 4 weeks in South Africa researching for a journalism class • Researching the living environment of South Africans • He slept in a hotel but its believe that he caught the disease by spending most of the time living in their environment.

23. Living conditions he visited http://d1520793.u66.hosting365.ie/images/khayelitsha_1.jpg

24. Daniel Stevens • Reported that he could see a small inflammation in his stomach and had a high fever • Immediately was drove himself to the hospital • Traveled with other classmates, none of them had this symptoms

25. Hematologist A hematologist is a doctor that specializes in the treatment of blood disorders. Common blood disorders that a hematologist checks for or detects are anemia, sickle-cell, and hemophilia. These diseases are detected by the doctor giving blood and function tests. They consult with their patients and understand their symptoms in order to diagnose them with the blood disorder.

26. Malaria • Infection: Not life long (curable) • Symptoms: High fever, chills, headache, muscle aches, tiredness and nausea • Complications: coma, low blood sugar, if untreated it will lead to death

27. http://factsanddetails.com/media/2/20110306-leishma%20cdc%20%20vl_enlarged_spleen.jpghttp://factsanddetails.com/media/2/20110306-leishma%20cdc%20%20vl_enlarged_spleen.jpg Complications of Malaria

28. How’s Daniel Doing • His malaria was cured • Plasmodium parasite is gone • Graduated college and majored in journalism

29. References " Hematologist Job Description, Career as a Hematologist, Salary, Employment - Definition and Nature of the Work, Education and Training Requirements, Getting the Job - StateUniversity.com ." Job Descriptions and Careers, Career and Job Opportunities, Career Search, and Career Choices and Profiles - StateUniversity. N.p., n.d. Web. 6 June 2012. <http://careers.stateuniversity.com/pages/7828/Hematologist.html>. Assays, In Vitro Binding. "Cell Biology of Plasmodium." Tulane University. N.p., n.d. Web. 6 June 2012. <http://www.tulane.edu/~wiser/malaria/cmb.html>. "Infectious Disease Specialist - Infectious Disease Expert & Consultant." Infectious Disease Specialist - Infectious Disease Expert & Consultant. N.p., n.d. Web. 6 June 2012. <http://www.infectiousdiseasemd.com/>. "Malaria - MayoClinic.com." Mayo Clinic. N.p., n.d. Web. 6 June 2012. <http://www.mayoclinic.com/health/malaria/DS00475>. "Physician Assistant Job Description." Health Care Salary Online . N.p., n.d. Web. 6 June 2012. <http://www.healthcaresalaryonline.com/physician-assistant-job-description.html>. SABO, ERIC. "Malaria - Symptoms, Diagnosis, Treatment of Malaria - NY Times Health Information ." Health News - The New York Times. N.p., n.d. Web. 6 June 2012. <http://health.nytimes.com/health/guides/disease/malaria/overview.html>. "The Best Over The Counter Medicines For Sinus Congestion | LIVESTRONG.COM." LIVESTRONG.COM - Lose Weight & Get Fit with Diet, Nutrition & Fitness Tools | LIVESTRONG.COM. N.p., n.d. Web. 6 June 2012. <http://www.livestrong.com/article/75887-over-counter-medicines-sinus-congestion/>.

30. References (cont) "The Best Over The Counter Medicines For Sinus Congestion | LIVESTRONG.COM." LIVESTRONG.COM - Lose Weight & Get Fit with Diet, Nutrition & Fitness Tools | LIVESTRONG.COM. N.p., n.d. Web. 6 June 2012. <http://www.livestrong.com/article/75887-over-counter-medicines-sinus-congestion/>.