Skip to Content

Revolt on the Tuberculosis Ward


Author(s)

Joyce A. Shaw
School of Arts and Sciences
Endicott College
jshaw@endicott.edu

Abstract

Monique is a 30-year-old Haitian woman with advanced pulmonary tuberculosis who has been transferred from a tuberculosis sanatorium to a large general hospital in Port au Prince after developing a secondary infection with Bacteroides fragilis at the site of her chest tube insertion. The patients on the hospital ward were disgusted by the foul smell of her wound drainage and wanted her removed from the unit. In this directed case, students investigate the characteristics of Mycobacterium tuberculosis and Bacteroides fragilis and review the anatomy and physiology of the respiratory system to help determine whether to keep the chest tube in place or remove it. Using statistics from websites of the World Health Organization, students also must balance the different social, cultural, and medical conditions that exist in Haiti while they formulate a recommendation as to how to end the patient revolt on the tuberculosis unit.  Originally designed for use in a general microbiology course, the case could also be suitable for an upper-level pathophysiology or clinical microbiology course.


Objectives

  • Explain the epidemiology of tuberculosis.
  • Define the terms incidence, prevalence, and mortality.
  • Compare tuberculosis in Haiti and the United States.
  • Describe the causative microorganism, symptoms, and pathology associated with tuberculosis.
  • Identify anatomy of the thoracic cavity and specifically the pleural space.
  • Summarize phenotypic and growth characteristics of Mycobacterium tuberculosis.
  • Compile a list of risk factors for TB in developing countries.
  • Explain the precautions that must be observed when dealing with active tuberculosis.
  • Evaluate the effect of a secondary infection with Bacteroides fragilis in a patient with tuberculosis.
  • Compare primary versus secondary infections.
  • Identify routes of entry of pathogens into humans.
  • Compare local versus systemic infections.
  • Summarize phenotypic and growth characteristics of Bacteroides fragilis.

Keywords

Respiratory system; respiratory disease; infectious disease; bacteria; tuberculosis; secondary infection; Mycobacterium tuberculosis; Bacteroides fragilis; Haiti

Educational Level

Undergraduate lower division, Undergraduate upper division

Format

PDF

Type Methods

Dilemma/Decision, Directed, Discussion

Language

English

Subject Headings

Microbiology  |   Medicine (General)  |   Nursing  |   Public Health  |  


Date Posted

10/25/2012

Teaching Notes

Case teaching notes are password-protected and access to them is limited to paid subscribed instructors. To become a paid subscriber, begin the process by registering.

Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

Answer Key

Answer keys for the cases in our collection are password-protected and access to them is limited to paid subscribed instructors. To become a paid subscriber, begin the process by registering.

Comments