CASE 13
Let's Evaluate the young woman!
Create By: 620161776 620164800 620164741
Start
THE CASE
A young woman upon visiting the health centre at her University presented with Fever of acute onset of >101.3oF (38.5oC) and severe arthralgia/arthritis not explained by other medical conditions.
THE CASE
The other features were noted upon physical examination and further questions asked by the centre’s doctor are, Headache, Diffuse back pain, Rash, Maculopapular (In children, may be bullous lesions), Myalgia, Nausea, Vomiting, Conjunctivitis.
THE CASE
She had visited her aunt who lived in Sea Centre a community located
near the swamps near River Mews. The patient visited her auntie within two weeks prior to the onset of symptoms.
Well she's not doing too well....
The possible diagnosis are:
Zika Virus
West Nile Virus
Chikungunya Virus
Dengue Virus
THE CASE
The patient had also noted that her cousin was complaining of headache and joint pain.
Upon checking, the centre confirmed that a month previous two patients presented with
similar symptoms and an alert was out for a virus that was going around, however test
results for the patients were not in so no definitive diagnosis was stated.
How could we find out more?
Based on the observed symptoms the tests that could be done to aid diagnosis are:
ELISA
PRNT
RT-PCR
Other conditions that could be considered in the differential
- Get adequate information about the patient's travel history.
- Report when symptoms were displayed in the patient and when sample was collected.
- Unusual immunological status of patient
Lets Investigate further...
The algorithm that could be flowed to investigate these conditions:
KEY
quantitative Reverse Trascriptase Polymerase Chain Reaction Immunoglobulin M Antibody Capture Enzyme Linked Immunosorbet Assay Plaque Reduction Neutalization Test
Diagnosis
After the tests were performed it was deduced that the young woman was suffering due to CHIKV
How to proceed...?
Should we contact the Ministry of health and give considerations to the patient's living surroundings and contact?
YES?
NO?
End of the Presentation!
References
References
Balzer, D. (2023, July 3). West Nile virus: What you need to know. Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/discussion/west-nile-virus-what-you-need-to-know/ CDC. (2020, March 6). Culex Mosquito Life Cycle | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/mosquitoes/about/life-cycles/culex.html Colpitts, T. M., Conway, M. J., Montgomery, R. R., & Fikrig, E. (2012). West Nile Virus: Biology, Transmission, and Human Infection. Clinical Microbiology Reviews, 25(4), 635–648. https://doi.org/10.1128/cmr.00045-12
European Centre for Disease Prevention and Control. (2019, March 18). Aedes albopictus - Factsheet for experts. European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/disease-vectors/facts/mosquito-factsheets/aedes-albopictus Funny Mosquito Images – Browse 5,442 Stock Photos, Vectors, and Video. (n.d.). Adobe Stock. https://stock.adobe.com/search?k=funny+mosquito
References
How to Diagnose Mosquito-Borne Diseases. (n.d.). Today’s Clinical Lab. https://www.clinicallab.com/how-to-diagnose-mosquito-borne-diseases-22666 Johnson, B. W., Russell, B. J., & Goodman, C. H. (2016). Laboratory Diagnosis of Chikungunya Virus Infections and Commercial Sources for Diagnostic Assays. Journal of Infectious Diseases, 214(suppl 5), S471–S474. https://doi.org/10.1093/infdis/jiw274 Malhotra, K., Ramanathan, R., Synowiec, A., & Rana, S. (2014). Rare ocular manifestation in a case of West Nile virus meningoencephalitis. Annals of Indian Academy of Neurology, 17(1), 95. https://doi.org/10.4103/0972-2327.128564 Pan American Health Organization. (n.d.). Chikungunya - PAHO/WHO | Pan American Health Organization. Www.paho.org. https://www.paho.org/en/topics/chikungunya
References
TOOL FOR THE DIAGNOSIS AND CARE OF PATIENTS WITH SUSPECTED ARBOVIRAL DISEASES DENV CHIKV ZIKV. (n.d.). Retrieved November 12, 2023, from https://iris.paho.org/bitstream/handle/10665.2/33895/9789275119365_eng.pdf World Health Organization. (2023). Zika virus disease. Www.who.int. https://www.who.int/health-topics/zika-virus-disease#tab=tab_1
Restart
The Ministry of Health should be notified as they can intiate fogging activities and educational campaings which will aid in vector control.
Reverse Transcriptase - Ploymerase Chain Reaction
Retrieved from: https://www.sigmaaldrich.com/JM/en/technical-documents/technical-article/genomics/qpcr/rt-qpcr
In this test viral RNA is converted into cDNA and them amplified a numerous amount of times until it is detectable.
Symptoms:
Fever
Headaches
Myalgia
Vomiting
Rash
Symptoms:
Fever
Severe joint pain
Myalgia
Headache
Nausea
Fatigue
Rash
Enzyme Linked Immunosorbeny Assay
Retrieved from: https://link.springer.com/protocol/10.1007/978-1-4939-3618-2_6
The Ministry of Health should be notified as they can intiate fogging activities and educational campaings which will aid in vector control.
Plaque Reduction Neutralization Test
Quantifies the amount of neutralizing antibody in serum samples by calculating the percentage of reduction of virus activity, as the concentration of virus used is usually constant.
Symptoms:Fever
Rash
Conjunctivitis
Myalgia
Joint pain
Headache
Symptoms
Fever
Severe joint pain
Myalgia
Headache
Nausea
Fatigue
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Transcript
CASE 13
Let's Evaluate the young woman!
Create By: 620161776 620164800 620164741
Start
THE CASE
A young woman upon visiting the health centre at her University presented with Fever of acute onset of >101.3oF (38.5oC) and severe arthralgia/arthritis not explained by other medical conditions.
THE CASE
The other features were noted upon physical examination and further questions asked by the centre’s doctor are, Headache, Diffuse back pain, Rash, Maculopapular (In children, may be bullous lesions), Myalgia, Nausea, Vomiting, Conjunctivitis.
THE CASE
She had visited her aunt who lived in Sea Centre a community located near the swamps near River Mews. The patient visited her auntie within two weeks prior to the onset of symptoms.
Well she's not doing too well....
The possible diagnosis are:
Zika Virus
West Nile Virus
Chikungunya Virus
Dengue Virus
THE CASE
The patient had also noted that her cousin was complaining of headache and joint pain. Upon checking, the centre confirmed that a month previous two patients presented with similar symptoms and an alert was out for a virus that was going around, however test results for the patients were not in so no definitive diagnosis was stated.
How could we find out more?
Based on the observed symptoms the tests that could be done to aid diagnosis are:
ELISA
PRNT
RT-PCR
Other conditions that could be considered in the differential
Lets Investigate further...
The algorithm that could be flowed to investigate these conditions:
KEY
quantitative Reverse Trascriptase Polymerase Chain Reaction Immunoglobulin M Antibody Capture Enzyme Linked Immunosorbet Assay Plaque Reduction Neutalization Test
Diagnosis
After the tests were performed it was deduced that the young woman was suffering due to CHIKV
How to proceed...?
Should we contact the Ministry of health and give considerations to the patient's living surroundings and contact?
YES?
NO?
End of the Presentation!
References
References
Balzer, D. (2023, July 3). West Nile virus: What you need to know. Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/discussion/west-nile-virus-what-you-need-to-know/ CDC. (2020, March 6). Culex Mosquito Life Cycle | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/mosquitoes/about/life-cycles/culex.html Colpitts, T. M., Conway, M. J., Montgomery, R. R., & Fikrig, E. (2012). West Nile Virus: Biology, Transmission, and Human Infection. Clinical Microbiology Reviews, 25(4), 635–648. https://doi.org/10.1128/cmr.00045-12
European Centre for Disease Prevention and Control. (2019, March 18). Aedes albopictus - Factsheet for experts. European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/disease-vectors/facts/mosquito-factsheets/aedes-albopictus Funny Mosquito Images – Browse 5,442 Stock Photos, Vectors, and Video. (n.d.). Adobe Stock. https://stock.adobe.com/search?k=funny+mosquito
References
How to Diagnose Mosquito-Borne Diseases. (n.d.). Today’s Clinical Lab. https://www.clinicallab.com/how-to-diagnose-mosquito-borne-diseases-22666 Johnson, B. W., Russell, B. J., & Goodman, C. H. (2016). Laboratory Diagnosis of Chikungunya Virus Infections and Commercial Sources for Diagnostic Assays. Journal of Infectious Diseases, 214(suppl 5), S471–S474. https://doi.org/10.1093/infdis/jiw274 Malhotra, K., Ramanathan, R., Synowiec, A., & Rana, S. (2014). Rare ocular manifestation in a case of West Nile virus meningoencephalitis. Annals of Indian Academy of Neurology, 17(1), 95. https://doi.org/10.4103/0972-2327.128564 Pan American Health Organization. (n.d.). Chikungunya - PAHO/WHO | Pan American Health Organization. Www.paho.org. https://www.paho.org/en/topics/chikungunya
References
TOOL FOR THE DIAGNOSIS AND CARE OF PATIENTS WITH SUSPECTED ARBOVIRAL DISEASES DENV CHIKV ZIKV. (n.d.). Retrieved November 12, 2023, from https://iris.paho.org/bitstream/handle/10665.2/33895/9789275119365_eng.pdf World Health Organization. (2023). Zika virus disease. Www.who.int. https://www.who.int/health-topics/zika-virus-disease#tab=tab_1
Restart
The Ministry of Health should be notified as they can intiate fogging activities and educational campaings which will aid in vector control.
Reverse Transcriptase - Ploymerase Chain Reaction
Retrieved from: https://www.sigmaaldrich.com/JM/en/technical-documents/technical-article/genomics/qpcr/rt-qpcr
In this test viral RNA is converted into cDNA and them amplified a numerous amount of times until it is detectable.
Symptoms:
Fever Headaches Myalgia Vomiting Rash
Symptoms:
Fever Severe joint pain Myalgia Headache Nausea Fatigue Rash
Enzyme Linked Immunosorbeny Assay
Retrieved from: https://link.springer.com/protocol/10.1007/978-1-4939-3618-2_6
The Ministry of Health should be notified as they can intiate fogging activities and educational campaings which will aid in vector control.
Plaque Reduction Neutralization Test
Quantifies the amount of neutralizing antibody in serum samples by calculating the percentage of reduction of virus activity, as the concentration of virus used is usually constant.
Symptoms:Fever Rash Conjunctivitis Myalgia Joint pain Headache
Symptoms
Fever Severe joint pain Myalgia Headache Nausea Fatigue