A 24-year old female automotive
technician presents herself at the doctorís office. She complains of fever and
of pain in her left hand.
On physical examination,
the patient had a deep wound on her left palm that was oozing pus. She had purplish,
red streaks running up her left arm. She had enlarged lymph nodes at the elbow
and under her arm. The patientís skin was warm and dry.
In her history, the patient
had punctured her left palm with sharp metal from the undercarriage of a "real
cherry" 1977 Malibu about a week earlier. She said the wound had bled for
a few minutes and she thought that she had washed it "real good" with soap and
water. She had covered the wound with a large "band-aid" and gone back to work.
She developed a fever about three days later. For the past couple of days, she
"did not feel so good" and had vomiting and diarrhea.
- What type of infection
do you believe she has in this hand?
- Pasteurella multocida
- From complaint and physical
examination, which of the symptoms lead you to your choice of agent?
- the fever and pain
in the hand
- the fever, wound
with oozing pus and enlarged lymph nodes
- the lymph nodes
and red streaks
- the warm dry skin
- the pain, red streaks
and enlarged lymph nodes
- From the history, which
of the information confirmed your choice?
- The wound had bled
for a while.
- The wound was cleaned
with soap and water.
- The wound had been
covered and had perhaps become anaerobic.
- She had diarrhea
- The cut was from
a rusting car frame.
- Which of the following
is most likely to follow this infection?
- gangrene and amputation
- toxic shock syndrome
- muscle spasms
- neurological disfunction
of the hand