An eighteen year old student presents with a history of diarrhoea. He has just returned from a three-month visit to India. During the first weeks of his visit he developed diarrhoea, which settled after treatment. A few days before his return he developed more severe diarrhoea associated with abdominal pain and a loss of appetite. He is passing several small volume stools a day which are blood stained. On examination he is thin and dehydrated. He has generalised abdominal tenderness and active bowel sounds. Other systems are normal. The results of investigations are as follows:
|White cell count||12 x 109/L with 80% neutrophils|
|Faecal sample||Blood and mucus present|
|Bacterium isolated from faeces||Gram negative, does not ferment lactose, serotype 1 secretes an exotoxin. Non- motile straight rod.|
Section A. Unseen questions Diet 1
result. 8 marks
described in this case. 4marks Section B. Answer 2 out of 3
control procedures. 20 marks
resulting infection(s). 20 marks
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