Patient 4

Patient 4: Ng Ming En
Complaints: severe vomiting, diarrhea, abdominal cramps
Diagnosis: Food Poisoning

Findings:


Test to be done: Stool culture
Abnormal results may indicate an intestinal infection.

Other stool tests such as gram stain of stool, and stool ova and parasites exam are to be done in addition to the culture.

1. Gram stain: Abnormal results would mean the presence ofintestinal infection. Stool cultures and more sophisticated tests can help to diagnose the cause of the infection.

2. Stool ova and parasites exam
Stool ova and parasites exam is an analysis of stool to check for the presence of a parasite or worm-like infection of the intestine. A small smear of stool is placed on a microscope slide and examined.

Firstly, before culturing, observe the texture of the stool; watery, bloody or normal? Then, culture on plate. gram staining is to be done. Then observe the morphology. If it is a –ve baccili, proceed to oxidase test. If it is oxidase –ve, proceed to do these 5 tubes: KG,SC, Urea, MOT, IND.

Possible microorganisms that can cause food poisoning:
S aureus
E. coli enteritis
Salmonella
Campylobacter
Cholera
Botulism
Listeria
Bacillus cereus
Yersinia

FYI:
Yersinia is a non-lactose fermenter, urease +ve, oxidase –ve, and non-motile. Diarrhea is watery to bloody.
Campylobacter is motile, and oxidase –ve. Selective media are needed, with anaerobic incubation.
Vibrio cholere is oxidase +ve, and grow at high pH(8.5-9.5).
V. parahaemolyticus is able to grow well on BP. And stool is watery to bloody.

Posted by Nora Binte Ahmad