A 27-year old white female presented at the walking clinic of her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender joints, and complained of a headache, a stiff neck and a backache. The physician noticed a circular "rash" about 5 inches in diameter, with a bright red leading edge and a dim center in the form of a "bull's eye". The physician noted an irregular heart beat. The patient complained of lack of ability to concentrate.

The patient gave the following history: She is a graduate student in the wildlife program at the university in town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of biting flies, mosquitoes and ticks in the area. She felt well until about 2 weeks after returning to her home. Since that time, many of her symptoms had progressed. She finally found that she could take it no more.

 Each illness is caused by a bacterium (NOT viral)

 Choose one of the three cases and complete the assignment by following the guidelines.

Write a typed, well constructed (complete sentences, proper grammar) report of not more than three double spaced pages (4 points).

Devote at least one paragraph to answering each of the 6 questions. (8 points each)

1. What microorganism causes this disease?
2. What is your best diagnosis of this case?
3. What features are critical to your diagnosis?
4. What further steps should be taken to clear up the problem?
5.  How is this disease transmitted?
6. What symptoms might the patient develop if the disease is not treated? What is the prognosis with treatment?

Include a reference section with at least 4 citations including at least one published reference. Use resources such as microbiology text books, encyclopedias, HCC Library databases (e.g. Pro Quest Biology, Pro Quest Nursing) journals and online medical sites to research these questions. Indicate the source of information you found in ACS or MLA format. Do not forget to include in-text citations every time you borrow someone’s idea, even if you paraphrased it. Be sure to include the publication date.  Comment on the reliability of the source (why you think this source is reliable) under each reference. (8 points)

All references must be cited, and direct quotes from the references must be indicated as such, using quotation marks.However, in science writing, direct quotes are seldom used. Instead, paraphrase the information in the reference, and supply the citation.  In the case of plagiarism, all students involved will receive a “0” on this assignment.  Thereafter, plagiarism will be handled according to the College’s Academic Honesty Policy, with possible failure of the course and suspension from the College.

 Please submit your case studies through Canvas.

Case 1

 A 27-year old white female presented at the walking clinic of her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender joints, and complained of a headache, a stiff neck and a backache. The physician noticed a circular "rash" about 5 inches in diameter, with a bright red leading edge and a dim center in the form of a "bull’s eye". The physician noted an irregular heart beat. The patient complained of lack of ability to concentrate.

The patient gave the following history: She is a graduate student in the wildlife program at the university in town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of biting flies, mosquitoes and ticks in the area. She felt well until about 2 weeks after returning to her home. Since that time, many of her symptoms had progressed. She finally found that she could take it no more.

Case 2

At the Mount Union hospital, a 5-year old white male child in good general health and physical condition was presented at the Saturday walk-in clinic by his mother. He was brought in because he had a fever, was cranky and had complained of a sore throat for about 24 hours. On physical examination by the attending resident, the patient had a fever of 39.3C, and he had considerable swelling and drainage of the pharynx and in the conjunctivae. His tonsils were enlarged and coated with a white patchy exudate. He had a red throat and swollen anterior cervical lymph nodes. His ears were clear. His chest sounded clear and he had no additional remarkable findings on routine examination.

Case 3

A 4-year old girl presents at the emergency room with bloody diarrhea, fever and vomiting. The child’s mother reports that the child has had these symptoms for about 24 hours and she has not passed any urine for about 12 hours.

The child is enrolled in a day care center and the group had recently made a field trip to a fast food place to learn about different jobs. The children had a lunch of ground beef, fries and cola after meeting with different workers. This field trip was 4 days earlier on Friday. The child had a temperature of 39C and showed physical signs of dehydration. Blood samples drawn showed evidence of greatly reduced kidney function and lysed red blood cells.