CASE HISTORY Robert,a 21-Year-Old Software Salesman from Dallas,Texas,presented to the Parkland Hospital

question 49

Essay

CASE HISTORY
Robert,a 21-year-old software salesman from Dallas,Texas,presented to the Parkland Hospital emergency room with three days of cramping pain in the midgastric and lower abdominal areas.He had no nausea,vomiting,or diarrhea.Upon examination,the patient screamed in severe pain when the clinician pressed on his lower right abdomen.Blood samples were obtained and sent for bacteriological culture.A blood culture bottle incubated in air appeared sterile,whereas another blood culture bottle placed in a special chamber that removed oxygen grew thick with bacteria.A subsequent exploratory laparoscopy,in which a small incision is used to perform surgery and minimize scarring,revealed a grossly inflamed appendix that released a liter of pus when removed.The diagnosis was appendicitis caused by the anaerobic bacterium Bacteroides fragilis-a common intestinal microbe.
How should the microbe causing Robert's infection be cultured? Will all of the microbes present in a sample taken from the site of his infection be able to grow in this culture? Explain your answer.

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Definitions:

Destroyed

To damage something so badly that it no longer exists, works, or has value.

Common Carrier

is a person or company that transports goods or people for any person or company and that is responsible for any possible loss of the goods during transport.

Independent Contractor

A person or entity engaged in a work performance agreement who is not considered an employee and does not receive employee benefits.

Agent

An individual authorized to act on behalf of another person or entity, often in business transactions or negotiations.