Reproductive Organ Case Studies - Part I

Return to the Microbiology Menu.

CASE 1

(Click here to go to the answers)

A 42-year-old man spends two weeks in Africa, working with an international relief group that interacts with young children. Two days after returning to the U.S., he develops a low-grade fever that is accompanied by myalgias, anorexia, and malaise. The following day, he notices a distinct swelling and tenderness in the area between his ear lobe and the angle of his jawbone, initially on one side of his face and later on both sides. The pain and swelling worsen over the next 36 hours or so, and the man finds it increasingly difficult to eat, swallow, or talk. On the fourth day of his illness, he develops severe pain, swelling, and tenderness in his left testis, along with a more obvious fever and a slight earache in both ears. At this point, the man seeks medical attention. Vital signs are normal except for fever (39ºC). On physical examination, he is found to have pronounced bilateral swelling and tenderness in the parotid area, and the orifices of the Stensen's ducts are red and swollen. His left testis is swollen to at least two times its normal size and is extremely tender, and there is obvious scrotal erythema. The man is pretty sure that he has never experienced symptoms like these before. When asked about his immunization history, he says that he never received the various childhood vaccinations that are routinely administered in the U.S. because his parents did not believe that they were safe.


Question 1.1: What is the most likely diagnosis?

Question 1.2: How typical is this case?

Question 1.3: What other complications are possible?

Question 1.4: What are the basic characteristics of the causative agent?

Question 1.5: How is this disease transmitted?

Question 1.6: How is this disease treated?

Question 1.7: How is this disease prevented?



CASE 2

(Click here to go to the answers)

A 23-year-old male graduate student at a major university experiences mild dysuria and an occasional scant, whitish urethral discharge for several days. He then develops a low-grade fever and tenderness in the region of his scrotum. The tenderness becomes increasingly uncomfortable and painful over the next 24 hrs, so he goes to the student clinic on his campus for advice. Vital signs are normal, except for a mild fever (38ºC). Examination of his scrotum reveals unilateral pain and marked tenderness, with swelling and erythema. There are no other remarkable physical findings. A history is taken and the student indicates that he has been sexually active with several different partners during the past few weeks and that he doesn't like to use condoms.


Question 2.1: What is your preliminary diagnosis?

Question 2.2: What tests should you perform?

Question 2.3: What is the most likely causative agent?

Question 2.4: What other microbes cause this disease?

Question 2.5: What other conditions should be considered in a case like this?

Question 2.6: How can this case be treated?



CASE 3

(Click here to go to the answers)

A 24-year-old sexually active woman who uses an oral contraceptive recently underwent a successful course of antibiotic treatment for a gonococcal infection. For the past two days, she has been experiencing intense vulvar and vaginal pruritus, along with a thick "cheesy" vaginal discharge. The symptoms are sufficiently irritating that she seeks medical advice. Her vital signs are normal. On physical examination, the vulva is found to be swollen and erythematous. There are a number of adherent, dry, white, curd-like patches of material attached to the vaginal mucosa. There is no noticeable odor associated with the infection, and there are no other remarkable findings.


Question 3.1: What is your preliminary diagnosis?

Question 3.2: What tests should you perform?

Question 3.3: What is the most likely causative agent?

Question 3.4: What is the differential diagnosis and how are the most similar conditions

Question 3.5: How prevalent is this disease?

Question 3.6: Did antibiotic treatment play a role in this disease?

Question 3.7: How should this case be treated?

Return to the Microbiology Menu.