Key Points in Hanaa’s history: Infection and potential complications

by | Sep 14, 2024 | Health

 

Mr. Mohamed Ali is a 55 year old farmer who lives with his wife Amena and 6 children in a 3 room flat in a small village near Mansoura city. His eldest daughter, Wafaa is used to suffer recurrent attacks of acute tonsillitis as a child. When she got married, she was diagnosed with rheumatic heart disease and died during delivery of her first child due to rheumatic heart disease.

His youngest daughter, Hanaa is an 8 year old school girl who missed school today because she could not get up in the morning. She was feeling hot and had difficult painful swallowing. Hanaa mentioned that her best friend Farida had a similar condition 2 days ago. Her mother took her to the doctor who checked her medical records and found that this was the third time that she had this illness within one year.

On physical examination, Hanaa had a temperature of 39 C and appeared acutely ill. She has tonsillitis with intense redness and edema of the mucous membranes, with purulent exudates and enlarged tender cervical lymph nodes.

A throat swab was obtained for culture, which showed Gram positive cocci . Antigen detection test was performed on another throat swab and confirmed group A streptococcal infection. High antistreptolysin O titer (ASO) was estimated in the patient’s serum. Twenty four hours later, cultures on blood agar showed beta hemolysis.

What are the key points in the history?

What are plans of management of this case?

If put drug should be the best drug to be used

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

 

 

Key Points in Hanaa’s history

1. Family Background: Mr. Mohamed Ali lives in a small flat with his wife and six children, indicating a potentially crowded living situation which might contribute to the spread of infections.

2. Previous Health Issues: The eldest daughter, Wafaa, had a history of recurrent tonsillitis as a child, which later progressed to rheumatic heart disease. This family history of rheumatic fever may suggest a genetic or environmental predisposition within the family to streptococcal infections.

3. Current Illness of Hanaa: Hanaa, the youngest daughter, is an 8-year-old who has missed school due to acute illness characterized by:

– Fever (39°C)
– Painful swallowing (odynophagia)
– Intense redness and edema of the tonsils
– Purulent exudates
– Enlarged and tender cervical lymph nodes

4. Epidemiological Link: Hanaa’s best friend, Farida, had a similar condition two days prior, indicating a possible outbreak of streptococcal infection in their community.

5. Recurrent Illness: This is the third episode of similar illness for Hanaa within one year, suggesting a pattern of recurrent tonsillitis, likely due to group A streptococcal infection.

6. Laboratory Findings:

– Throat swab culture shows Gram-positive cocci.
– Antigen detection test confirms group A streptococcal infection.
– High ASO titer indicates recent streptococcal infection.
– Blood agar culture shows beta-hemolysis.

Plans of Management

1. Antibiotic Therapy: Initiate treatment with appropriate antibiotics to eradicate the streptococcal infection. The first-line treatment for confirmed group A streptococcal infection is:

– Drug of Choice: Penicillin V or Amoxicillin for 10 days. If the patient has a penicillin allergy, consider using clindamycin or azithromycin.

2. Symptomatic Treatment: Provide supportive care to alleviate symptoms:

– Analgesics/antipyretics (e.g., acetaminophen or ibuprofen) to reduce fever and throat pain.
– Encourage oral fluids to prevent dehydration.
– Soft diet to ease swallowing difficulties.

3. Monitoring and Follow-up: Schedule follow-up appointments to monitor Hanaa’s progress and ensure that symptoms resolve and treatment is effective. Repeat throat cultures may be necessary if symptoms persist.

4. Prevention of Complications: Educate the family about recognizing signs of rheumatic fever and ensuring timely medical intervention if symptoms arise. Discuss preventive measures such as proper hygiene practices (frequent handwashing, avoiding close contact with infected individuals).

5. Consideration for Tonsillectomy: If Hanaa continues to experience recurrent episodes of strep throat despite appropriate treatment, a referral for an evaluation for a possible tonsillectomy may be warranted.

Conclusion

In summary, the key points in Hanaa’s history highlight a recurrent and significant streptococcal infection, necessitating prompt antibiotic treatment, symptomatic relief, and preventive education for the family. By addressing both the current infection and potential complications, healthcare providers can significantly improve Hanaa’s health outcomes.

 

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