VI SEM-INSEM II CASE STUDY DISCUSSIONS DEPT OF MICROBIOLOGY
CASE 1: A 25 year old recently married woman is concerned about a scanty offensive malodorous vaginal discharge. She states that the discharge is thin, grayish white and foul smelling. She does not complain of vulvar pruritis or soreness. Physical examination reveals presence of a homogenous grayish white watery discharge adherent to the vaginal walls that yields a fishy odor when mixed with KOH. 1. What is your diagnosis of the above case? 2. What are the possible differential diagnoses and how do you rule out them? 3. Mention briefly about the lab diagnosis of the sample collected from the patient? 4. What features in the above case would you think could strengthen your confirmation about the condition? 5. What are the complications that this patient can show if you leave untreated? 6. What is the treatment regime for this patient?
Case 2:
A 28 year old sexually active presents with crampy lower abdominal pain, yellowish vaginal discharge and general malaise. She also complaints of continuous low grade fever and reveals that the pain is exacerbated during and immediately after menstruation. She uses a copper intrauterine device for contraception. Physical examination reveals lower abdominal tenderness, bimanual pelvic exam demonstrates purulent vaginal discharge, bilateral adnexal tenderness and pain on movement of cervix (mucopurulent cervicitis). Microbiology lab reports the growth of both Neisseria gonorrhea on Thayer martin medium and Chlamydia trachomatis in cell culture. Laparoscopic examination revealed erythema and swelling of the fallopian tubes and noted seropurulent exudate on the tubal walls. 1. 2. 3. 4. What is your diagnosis of the above case? Mention few organisms which can cause this condition? What are the risk factors that predispose a person to this infection? What are the complications seen in patients who are not treated adequately with appropriate antibiotics?