Question

BUZZ, BUZZ! Oh, what terrible timing. Tom was in the middle of setting up an experiment in lab when his phone indicated that he had a voicemail from his 3-year-old's preschool. He finished up his immediate task and checked his messages. The preschool teacher was calling to let him know that his son, Theo, had a fever of 101.7°F and that he didn't seem to be feeling well and needed to be picked up early. Tom sighed and said he would be right there. He went back into lab, diluted back his bacterial culture, put it in the incubator, and decided to do the experiment tomorrow. When he drove to preschool and picked up Theo, he noticed Theo was lethargic and sad. Tom knew that kids get all sorts of random illnesses, so he took Theo home to see if he could figure out if anything else was wrong. Because Theo was 3 years old, he was able to tell his Dad that his throat hurt a lot as he kept rubbing his throat. Theo didn't seem any to be getting any worse, so everyone went to bed. In the middle of the night, Theo wakes up to vomit (repeatedly) and complains of stomach pain.

Tuesday, March 7, 2017

After a night of not very much sleep, Tom checked Theo's temperature again and saw that it was still high. Now he saw that Theo's cheeks were flushed and there was a rash consisting of pink, slightly raised bumps (no pustules) covering his cheeks, chest, and back. Tom placed a call to the pediatrician to set up an appointment for later that morning.

Required:
a. What disease is the boy likely suffering from? Explain your diagnosis.
b. Name and describe the pathogen that causes this disease.
c. Because Theo is going to be taken to the doctor, is it likely to the fatal? What if the year was 1900? Why?
d. Explain what is causing the rash.
e. If the boy was infected with the same pathogen and had the same signs and symptoms, but did not present with a rash, what would the disease diagnosis be?
f. What treatment would the doctor prescribe? Name one example and describe the mechanism of action
g. The boy was given a prescription and started having diarrhea. Is this normal? Why or why not?

Answer 1

Theo's symptoms suggest he might be suffering from Fifth disease, caused by parvovirus B19. With modern medical care, the disease is not typically fatal, unlike in 1900. The rash is an immune response to the virus, and the treatment likely involves fever reducers with diarrhea as a possible but unrelated symptom.

Step-by-step explanation:

Possible Diagnosis and Pathogen

The symptoms described for Theo (fever, lethargy, sore throat, vomiting, stomach pain, rash) mimic those associated with Fifth disease, also known as erythema infectiosum, which is caused by parvovirus B19. Theo's presentation with flushed cheeks and a pink rash on his body are characteristic of this illness. Considerations for a different diagnosis would be needed if he did not present with the rash.

Pathogen Description

Parvovirus B19 is the pathogen behind Fifth disease, spread through respiratory secretions from an infected individual. The disease mostly affects children and presents with a 'slapped cheek' appearance followed by a spreading rash.

Risk of Fatality

In contrast to 1900, today's medical advancements and antibiotics make it unlikely for Theo's condition to be fatal. In an earlier era without these treatments and less knowledge of disease management, the risk would have been higher.

Causes of the Rash

The rash from Fifth disease is due to the immune system's response to the infection from parvovirus B19.

Alternate Scenario Without Rash

Without the presence of a rash, the diagnosis could be challenging and may require the consideration of other illnesses such as strep throat or roseola, depending upon the full spectrum of symptoms.

Treatment Options

The doctor may prescribe supportive care for Theo, including fever reducers such as acetaminophen or ibuprofen. Due to the viral nature of the disease, antibiotics would not prove beneficial.

Side Effects of Treatment

Diarrhea is not a typical side effect of treatment with fever reducers, indicating that it could be either a continuation of the initial gastro-intestinal symptoms of Fifth disease or due to another underlying cause.