Unicellular Organism in Appendicitis! - USMLE Forums
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  #1  
Old 10-05-2012
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Microbiology Unicellular Organism in Appendicitis!

A previously healthy 36-year-old man comes to the emergency department 12 hours after the sudden onset of increasingly severe abdominal pain. He recently returned from a 3-week sailing trip around Central America and several Caribbean islands. His temperature is 38.3C (100.9F), pulse is 96/min, respirations are 18/min, and blood pressure is 130/72 mm Hg. Abdominal examination shows right lower quadrant tenderness. His leukocyte count is 2,200/mm3 (70% segmented neutrophils, 6% bands, 1% eosinophils, 20% lymphocytes, and 3% monocytes). Exploratory laparotomy and an appendectomy are done. Examination of the appendix shows multiple mucosal ulcers. Unicellular microorganisms are seen within the exudates at the base of the ulcers. Some of the microorganisms contain erythrocytes. Which of the following is the most likely source of this patient's infection?

(A) Being bitten by a sand fly
(B) Infection from a sexual partner
(C) Mosquito bite
(D) Undercooked freshwater fish
(E) Undercooked saltwater fish
(F) Water contaminated by human feces
(G) Water contaminated by infected snails
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Old 10-05-2012
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I think it's
G. Water contaminated by infected sails. Just random guess


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One day i will infect these microbes and they will search for "Anti-MEbiotic"....
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Old 10-05-2012
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guessing E) undercooked saltwater fish.....vibrio parahemolyticus

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Old 10-06-2012
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I think its E :sorry:
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Old 10-06-2012
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its case of amebiasis...............perfect history,,,,,,perfect finding during surgery.................most imp. give away is unicelluler organism..............so pt, got it from water infected with feces.......
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Old 10-06-2012
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my ans is entamoeba histolytica(ERYTHROPHAGOCYTOSIS)..ingestion water contaminated by human feces
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Old 10-06-2012
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its E.histolytica transmitted by ingestion of water contaminated with feces
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Old 10-06-2012
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I agree the answer !

F ... water infected with human faeces....(Entamoeba histolytica!)
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Old 10-06-2012
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Wanted to add a little bit. Entamoeba is interesting for two reasons.
1)The trophozoite ingests RBC's. And you can actually see the ingested RBC's in it's trophozoite form.
2) The cyst has multiple nuclei (with spokes.)
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