Case Study #7

On November 1, 2016, a 67 year-old male, Tom Preston, arrived at the emergency department of the local hospital in Madison, Wisconsin. He was complaining of shortness of breath and had a fever of 100.8 degrees Fahrenheit. He also had a swollen, red area on his right calf that when palpated felt warm and tender. Tom’s heart rate was elevated and he had vomited twice before arrival. While gathering information from Tom, he mentions he has been undergoing chemotherapy to get rid of any remaining colon cancer he had treated months ago (it was Stage 2 when treated). He is an avid outdoorsman that enjoys playing golf and fishing in his free time, especially now that he is retired. Blood tests reveal septicemia but it is unknown what is the specific agent – thus, the ideal antibiotic therapy may be difficult to find.

At other hospitals throughout Wisconsin, five other people have presented with similar symptoms. All were over the age of 65 and had a serious co-morbidity. Two of the patients also reported chills. Each hospital has had difficulty in determining the specific agent that may be causing these illnesses.

Q. What other questions would you ask Tom? Be specific and include them all here.

Q. Where would you like to do more sampling? Geographical (e.g. bodies of water, soil, etc.) Why?

Q. If your lab cannot identify the agent, where can you send specimens?

Q. What specimens would you send to a lab for analysis and what lab tests would you run?

Q. What agent or agents do you think are causing these illnesses and why?