CASE STUDY 1
The patient was a 19-year-old female. She was seen in the walk-in medical clinic with complaints of right-knee and right-shoulder pain, nausea, and vomiting. On physical examination, she had a swollen right knee and decreased range of motion of her right shoulder. She also had thick vaginal discharge. Her temperature was 38.4°C, and she had a WBC count of $15.7 \times 10^3/L$. She gave a history of having two recent sexual partners. Blood, vaginal, and joint fluid cultures were collected. A Gram's stain of blood culture showed numerous PMNs, but no organisms were seen. Both the vaginal culture and joint fluid were positive for the agent of infection.
1. What do you suspect to be the etiologic agent of her infection? What in her history/symptoms supports this conclusion?
The patient is a 19-years-old female with a history of two recent sexual partners, which increases the risk of sexual transmitted infection like gonorrhea.
Symptoms:
Joint pain right-knee and right shoulder, nausea, and vomiting, fever (38.4), thick vaginal discharge and elevated WBC ($15.7 \times 10^3/L$) is highly suggestive disseminated gonococcal infection.
2. What laboratory testing could be done as an organism work-up on these specimens? Describe the media you would use, biochemical testing, and carbohydrate utilization testing that you would do with the corresponding results for this suspected organism.
