OUR FINAL DIAGNOSIS

Murine typhus or rat-bite fever

Murine Typhus

- The patient shows common symptoms like high fever, severe muscle pain (myalgia) and dull red rash, which are also seen in the people infected with murine typhus.

- Since the disease occurs commonly in elderly and the patient is 85 years old, it is highly possible that the patient contracted murine typhus.

- His house is infested with rodents and rats, and he has the habit of feeding stray dogs and cats. Thus these made him widely exposed to the bacteria, as the main transmitters of the disease are fleas, rats and stray cats.

- Murine typhus may result in mild kidney failure which causes excessive urination at night, which explains why his mattress was soiled with urine.

Rat-bite Fever

- The patient shows common symptoms such as moderate fever, chills, a diffuse red rash, which are also seen in the people infected with Rat-bite fever. [1]

- It is caused by a bacterium (S.Moniliformis) which is transmitted from rodent to human via the rodent's urine or mucous secretions. [1]

- It can also be caused by the scratches and bites by rats. This is highly possible as his house is infested with cockroaches and fleas as well as rats.

- It is mostly found in Asia like Singapore and Japan.

References:
http://en.wikipedia.org/wiki/Main_Page > Rat-bite_fever (1)

These are the 5 possible diseases that we deduce the elderly man may be contracted with.

5 possible diseases:

Hantavirus
Leptospirosis
Murine Typhus
Rat-bite fever
Typhoid Fever

REASONS

Hantavirus pulmonary syndrome (HPS)
- a deadly disease transmitted by infected rodents through urine, droppings, or saliva
- symptoms like fever, chills, malaise, fatigue match with those symptoms that the patient had (1)





--> Transmission electron micrograph of the Sin Nombre Hantavirus (1)



Leptospirosis
- Transmitted through contact with water, food, or soil containing urine from infected animals like dogs, rats and mice. This may happen by swallowing contaminated food or water or through skin contact. (2)
- Symptoms like high fever, chills, rash, muscle aches, match with those symptoms that the patient had (2)
- Since he had a habit of feeding stray dogs and cat that might be infected with Leptospira, hence he might be infected through their urine and feces.







--> Scanning electron microscope of a number of Leptospira sp. bacteria atop a 0.1 µm polycarbonate filter(2)

Murine Typhus
- Transmitted through exposure to rat fleas or rat feces, or exposure to other animals such as cats and rats (3)
- Symptoms like extremely high fever, dull red rash, severe muscle pain, chills, match with those symptoms that the patient had (3)
- Might result in mild kidney failure which causes excessive urination at night, which explains why his mattress was soiled with urine.




--> Rickettsia typhi (Bacteria) (6)




Rat-bite fever
- Caused by bacteria, transmitted from rodent to human via the rodent's urine or mucous secretions (4)
- Symptoms like moderate fever, chills, a diffuse red rash, match with those symptoms that the patient had (4)
- Mostly found in Asia (4)

(7)

Typhoid Fever
- Caused by the bacterium Salmonella typhi, transmitted by ingestion of food or water contaminated with feces from an infected person (5)
- Symptoms like high fever, weakness, and rash of flat, rose-colored spots, match with those symptoms that the patient had (5)
- Might result in gastroenteritis, diarrhea, which explains the human excreta present on his mattress

--> Salmonella typhi bacteria (5)

References:
1. http://en.wikipedia.org/wiki/Main_Page > Hantavirus
2. http://en.wikipedia.org/wiki/Main_Page > Leptospirosis
3. http://www.nlm.nih.gov/medlineplus/ency/article/001363.htm > encyclopedia > article001363
4. http://en.wikipedia.org/wiki/Main_Page > Rat-bite_fever
5. http://en.wikipedia.org/wiki/Main_Page > Typhoid_fever
6. http://www.cdc.gov/ > Report > Fatal Rat-Bite Fever
7. http://www.genomenewsnetwork.org/ > Bacteria