Organism isolated from the blood culture

 

Case study:
Alice was 58 yrs old women live in New York. She was worked in pet grooming store. One day during a the grooming, a the had bitten her on her arm. According t dog’s owner, the had all his vaccination, so she don’t need to worry. Next day when Alice woke up with low fever and headache and her arm had blister around the bite and pain at the bite wound. She just ignored the symptom and took the painkiller. But the symptom get more worse next day, . she were to the local clinic where the doctor treated her an allergic reaction and Dr. told her, she will .el better soon in couple day. When symptom get worse Alice’s daughter took her to ER, when she was admitted to ER she had high fever and low blood pressure. she had muscle and join pain and also had diarrhea with stomach pain. Site of blister had pus and rash got worse. According to daughter Alice had history of Diabetes 2 and she had bitten by dog five days ago. Than Dr. ordered some blood culture and gave her cephalosporin antibiotic but she was not responding to treatment. Alice was ‘transferred from ED to ICU. Her blood Cultures became positive after. Hours with a gram negative fusiform rod that did not grow on MacConkey agar but organisms grow on blood or chocolate agar at 35 to 37 C. Than Alice’s antibiotic changed to ciprofloxacin, and she became ,febrile within 24 hr.
1. What is the likely organism isolated from the blood culture?
2. Why Alice was not responding to the cephalosporin?
3. How might this disease have been prevented?
4. What H., likely source of the organism?
5. What others infection you can get from dog bite?

 

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