- The results of the bacteria identification test indicate that the bacterial infection Anna has been diagnosed with is serratia marcescens.

- The results of the gram stain test indicate: 

- The results of the gross examination of colony morphology test indicate that bacteria is Serratia marcescens that caused Anna’s infection. The colors, elevation, and margin matched.

- The results of the urinalysis test indicate positive for bacterial infection. Further tests need to be performed to identify the type of bacteria.

Abnormalities found: Anna’s red blood cells are sickle shaped.

Results:

Red Blood Cell Count reduced levels

White Blood Cell Count increased levels

Lower than normal hematocrit - 20%

Lower than normal levels

Abnormal spleen, indicative of splenic sequestration

Positive for sickle cell anemia

Diagnosis:

Treatment:

Laboratory Analysis

Given Anna’s family history of cardiovascular disease and her stated symptoms, Anna will be sent for glucose tolerance testing to rule out diabetes. 

Follow-up/Diagnosis 

Anna has been diagnosed with diabetes. After testing her glucose levels, they spiked up and didn’t go back to normal. She is a Type 1 diabetic because her insulin levels stayed low at a consistent rate. 

The mucosa and wall of the esophagus are intact and gray-pink, without lesions or injuries. The gastric (stomach) mucosa is intact and pink without injury. The mucosa of the three parts of the small intestine, the duodenum, the jejunum, and the ileum, and the mucosa of the large intestine, the colon and rectum, appears normal. Approximately 125 ml of partially digested semisolid food is found in the stomach.

The following X-ray image was obtained of the heart and lungs before internal examination. Lungs appear normal with no infiltrates.

Examination of the heart revealed concentric left ventricular hypertrophy. There is also evidence of mild mitral valve prolapse (this means that the mitral valve does not close properly). 

Cardiac Testing

Patient completed a treadmill stress test. The patient experienced drastic increases in blood pressure as well as a few premature ventricular contractions (PVCs) on EKG during the exam. One run of ventricular tachycardia was noted. Additional monitoring using a Holter monitor is suggested given these abnormalities and the noted mitral regurgitation (going back to the aorta) (see below). The patient was only able to walk for 8 minutes before the test was concluded – max speed 3.5 mph at an elevation of 2%, and max blood pressure of 190/110. 

Due to EKG changes during the treadmill test and the patient complaint of chest pain, an angiogram was recommended to explore the cardiac vessels. Scans revealed a blockage in the left anterior descending coronary artery (not fully visible on the summary scan below). Angioplasty is recommended with the potential for stenting. 

Patient was evaluated by physical exam, blood work, cardiac stress test with electrocardiogram (EKG), and an echocardiogram. Results later prompted an angiogram. 

Laboratory Analysis