Reference no: EM133332999

Case Study: Patient S, 22 years old, was admitted to the infectious hospital on 18.03.2019, on the third day of the illness.

Complaints: diarrhea up to 8 times per day with liquid foamy feces of green-brown color with unpleasant smell, severe pain and slight swelling of knee-joints, increase of body temperature to 39,0ºC.

Anamnesis of illness: he became ill acutely 15.03.2019 at 9 o'clock p.m., when the body temperature increased to 38.0ºC, then rumbling in stomach, nausea, 3-times vomiting and diarrhea up to 8 times per day added. 16.03.2019 fever remained at 38.3ºC, diarrhea was up to 8 times per day with abundant liquid foamy feces of green-brown color with an unpleasant smell. On the second day slight swelling and pain of knee-joints appeared. He treated medicines independently, took probiotics, but the state of the patient didn't improve. 17.03.20019 by an ambulance he was hospitalized to the infectious hospital with diagnosis of salmonellosis.

Epidemiology anamnesis: the patient does not connect his disease with anything. Before the disease the patient ate borsh, boiled potato, fried meat, salad from fresh cucumbers and green onion seasoned by mayonnaise. Everything was fresh. Mayonnaise had been bought in the store the day prior. The parents of the patient also ate this food except salad.

Anamnesis of life: The patient had measles, scarlet fever and respiratory diseases before. Allergic anamnesis is negative. Vaccinations have been done according to age.

Objective status: The general state is of middle severity. Temperature is 38.8°C, HR is 96 beats per minute, BP is 110/70 mm Hg. Consciousness is clear. The turgor of skin is normal. The face is moderate hyperemic. Scleritis is present. Over the lungs there is vesicular breathing. Heart sounds are muffled, rhythm is correct, pulse is satisfactory. The tongue is coated with a gray cover. The abdomen is soft. There is rumbling in the right iliac area. The liver and spleen are not enlarged. The sigmoid isn't spasmodic. Padalka's symptoms are present. Stool is 8 times per day with liquid foamy feces of green-brown color with an unpleasant smell. The knee-joints are slight swelling, painful at palpation. Motions in knee-joints are limited through a great pain. The patient moves with crutches.

QUESTIONS:

1. Formulate and explain diagnosis.

2. What is the reason for a diagnostic error by the doctor of first-aid?

3. Name the auxiliary methods of diagnosis of this disease.

4. What are the factors and the routes of transmission for this disease?

5. Prescribe the treatment to the patient.