Case No: 1 A 47-year-old woman and her 51-year-old husband presented with paralysis of multiple cranial nerves and rapidly descending paralysis approximately 72 hours after ingestion of home-canned beans

Case No: 1 A 47-year-old woman and her 51-year-old husband presented with paralysis of multiple cranial nerves and rapidly descending paralysis approximately 72 hours after ingestion of home-canned beans. 1. What is the possible diagnosis? A. Amoebiasis B. Botulism C. Shigellosis D. Typhoid fever 2. What is the possible etiology of food poisoning? A. Clostridium sordellii B. Clostridium perfringens C. Clostridium botulinum D. Clostridium difficile 3. The most useful diagnostic tool is A. Identification of botulinum neurotoxin (type A) in the serum B. Stool analysis C. Abdominal Ultrasonography D. Blood picture 4. Choose the best therapeutic agent suitable for the potential diagnosis A. Antitoxin B. Antibiotics C. Antipyretics D. Vaccine —————————————————————————————- Case No: 2 A 33- years old male presents with watery diarrhea, vomiting, fever, and diffuse abdominal pain that began yesterday. Several of his coworkers with whom he has recently eaten are also ill. The most probable diagnosis is: A. TB enteritis B. Food poisoning C. AIDS D. Cl. difficile colitis –

CASE 1

A 19-year-old man is brought to the emergency department by his roommate. He has been experiencing abdominal pain of 6 hours’ duration with loss of appetite and vomiting. He reports 9/10 pain “all over,” greater on the right side; the pain is dull and is not improved or exacerbated by anything in particular. On physical examination, his temperature is 38.0° C (100.4° F), blood pressure is 120/70 mm Hg, pulse rate is 80/min, and respiratory rate is 10/min. His abdominal examination is notable for absent bowel sounds and severe tenderness on deep palpation in both the right and left lower quadrants. He is also tender on passive internal rotation of the right hip. WBC count is 14,000/mm3 , and urinalysis shows few RBCs and few WBCs.

What is the most likely diagnosis?

What is the pathogenesis of this condition?

What conditions should be included in the differential diagnosis?

What are the typical laboratory findings in this condition?

What are the typical imaging fi ndings in this condition?