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Case Study: Analysis of Cause of Death

So I am studying my micro book, and came across a case study. I am hoping a T.A may be able to assist me in answering the 4 questions.

The case study is as follows:

In the summer of 1999 you are working as a triage nurse in the Emergency department of a hospital. A young-athletic man in his early 20's is helped into the hospital by his girlfriend. He greets you and sits down, but is feverish and his breathing is labored. The girlfriend answers your questions for you. She says the symptoms began about 24 hours ago and seemed to worsen quickly. After listening to his chest you decide it may be pneumonia. You return him to the waiting room until an examination room is free.

45 minutes later the girlfriend starts screaming, "I think he's choking." You and the attending physician arrive and he is suffering from acute respiratory distress. Later that same evening the patient dies. Lab work reveals that the cause of the death was not bacterial. No other cases of this type are reported for the summer.

1. What might have killed him? (list)
2. What other facts might you have required to try and determine the nature of the infection?
3. Describe the transmission characteristics of suspected agent?
4. Why might it have been a poor idea to send the patient back to the waiting room?

Solution Preview

The case described above sounds very much like the SARS outbreak in 2003. This outbreak was due to the transmission of a virus that replicated in the cells of the respiratory tract, causing severe respiratory distress after a short incubation period.

1. What might have killed him?

The triage nurse\\\\\\\'s decision that the man is suffering from pneumonia is not consistent with the fact that the man was young and athletic, the short incubation period and the rapid progression of the disease to the point where his breathing is laboured and he is feverish. It sounds like a non-bacterial infection from those facts alone. Typically, a young, healthy man would be expected not to come down with a bacterial infection quickly (i.e. within one day) and to progress to pneumonia as his immune system should be able to fight the infection. It appears to be an infection by a new etiological agent to which the patient had not previously been exposed.

If the cause of his death ...

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