Problem
Adrian, 7 years old, was admitted because of on and off high-grade fever for two weeks relieved temporarily by paracetamol. The boy was diagnosed with mitral valve prolapse. One week prior to the onset of fever he underwent dental extraction but was not given prophylactic antibiotic. PE revealed grade 3/6 systolic murmur which was not previously noted. You as the attending physician requested for a blood culture.
A. What is your clinical impression? Why did you request for a blood culture?
B. When is the best time to extract the blood for culture? How many samples need to be extracted? How much blood to extract? Explain your answer.
C. What are your precautions before you proceed with the blood extraction? How do you prepare the site for extraction?
D. If you obtained more than one blood sample, how will you interpret if one sample has positive growth and the other sample is negative? Explain
E. Using a concept map, demonstrate the steps on how you are going to isolate the possible causative agents and how identify the most common causative agent. Make a CONCEPT MAP
F. What are the factors that may result in false negative blood culture results?