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MEDICAL DIAGNOSTIC II, SBD 3023 PARASITOLOGY SEMESTER MAY 2009

FACULTY OF HEALTH AND LIFE SCIENCES SBD 3023 MEDICAL DIAGNOSTIC II CASE STUDY 1 MAY SEMESTER 2009 _____________________________________________________________ Instructions
1. 2. 3. 4. 5. 6. Please follow all guidelines for your presentation inside Your REPORT should be typed on A4 paper, using Arial 11 and 1.5 line spacing. Use double spacing between paragraphs. Minimum pages : 3, maximum pages : 5 Plagiarism in all forms is forbidden. Students who submit plagiarized assignment will be disqualified. Your REPORT must be submitted (in group) on the same day of your presentation. Please list out your references.

BBM/ AZRINA ZAINAL ABIDIN

MEDICAL DIAGNOSTIC II, SBD 3023 PARASITOLOGY SEMESTER MAY 2009

CASE STUDY 1 The patient is a 39-year-old female farmer, a native of Sabah (East Malaysia). She was referred from a district hospital with complains of cough and fever for a duration of two weeks, associated with loss of appetite and loss of weight (6 kgs over one month). She had two past histories of previous admissions for left leg cellulitis. Patient had no history of traveling overseas. On examination, there was pallor, multiple palpable cervical and inguinal lymph nodes, hepatosplenomegaly and multiple healing ulcers on the left leg.Laboratory investigations revealed a hemoglobin of 7.29 g/dl and peripheral blood film showed a microcytic, hypochromic red blood cells. Total white blood cell count was 21x109/l with an increase in neutrophils and ESR of 80 mm/hr. Sputum examination carried out three times for acid-fast bacilli (AFB) was negative. Lymph node biopsy revealed a caseating granuloma. Stool examination was positive for the eggs of Fasciolopsis buski (Fig 1). The egg measures 140 x 72.5 m and is operculated. As was mentioned earlier, a distinction between eggs of Fasciolopsis buski and Fasciola hepatica is difficult to make. Since this patient is from Sabah (East Malaysia) and had no history of traveling overseas or to any areas endemic for F. hepatica, we identified the egg as being that of F. buski.

Fig 1Egg of Fasciolopsis buski from the patient showing a prominent operculum. Unstained, x 250.

BBM/ AZRINA ZAINAL ABIDIN

MEDICAL DIAGNOSTIC II, SBD 3023 PARASITOLOGY SEMESTER MAY 2009

Questions a) What test(s) would you perform to confirm current infection of this patient?
b) How will you differentiate this infection with other infections? c) Discuss about the symptoms of the patient.

d) What treatment would you give to this patient?


e) Discuss the best serological method can be use to diagnose this disease.

Prepare for a 20 minutes presentation based on the article given. Your presentation MUST include: o o o o o Introduction to the case study Your diagnosis of the case study ALL the answers for the questions given Additional information regarding the case study given Conclusion

REMINDER: Please do not exceed the time given for the presentation

BBM/ AZRINA ZAINAL ABIDIN