Reference no: EM133518769

Upon completion of your nursing degree, you decided to try the country life, and moved to a rural town in West Virginia, working for a small family practice. Around mid-September, a man in his late 40's comes in to your office. He has been suffering from an intermittent headache with a fever of 102-103°F for the past two weeks. The physician arrives while you are completing his vitals (nothing abnormal was noted). The physician takes the man's history, and performs a physical exam. The only clinical findings were a wound in late stages of healing on his left thumb and swelling of the axillary lymph nodes that were tender. When asked about the cut, the man replied that he cut himself skinning a rabbit some three weeks ago. Based on these findings, the physician orders blood to be drawn now and again in 4 weeks, prescribes a ten day regiment of streptomycin and orders the patient to come back if his symptoms don't get better after 1 week.

1. Based on the limited information above, the physician has made a diagnosis. What is it? What does it look like when gram stained?

2. What is the most likely reservoir of the causative agent in this case?

3. Why did the physician order blood to be drawn twice?

4. As part of the staff at the practice, there is a part time clinical microbiologist. Should they attempt to culture the microbe in house to confirm the diagnosis? Explain.

5. Infections like this one are zoonotic. Define zoonotic and list two additional zoonotic infections and their causative agents.