Case No. 003 · Case File

3 pages · one set per table · reusable ← Back to the case Worksheet
At the printer: print all 3 pages, one set per table or pair, and reuse them across periods. Students write on the Case 3 Worksheet, not on this file. Letter, portrait. Color is best, so students can read the lab results.
Medical Detectives · Case File No. 003Patient file · Marisol T.
Evidence 1–3
PatientMarisol T.
Age12
VisitDay 23
Height60 in.
Weight today86 lb
Weight in August89 lb

Evidence 1 · Vital signs at rest, in the clinic

Temperature100.9 °F
Blood pressure106/68
Pulse104 bpm
Breathing26 /min

Evidence 2 · The interview 23 days, in order

Day 0 · SaturdayScience-club fossil dig in dry hills. Hot, dry, and windy. Marisol dug in the main pit for 4 hours. "Dust was everywhere. I was coughing up dirt."
Day 9The family adopts a kitten named Pepper. Marisol and her brother Leo hold her every day.
Day 10First symptom: very tired all day. A dry cough starts, slowly.
Day 12Fever and a headache.
Day 13Urgent care says, "Maybe a bacterial chest infection." She starts a 10-day antibiotic.
Day 17Wakes up soaked in sweat at night. Her chest hurts on deep breaths. Knees and ankles ache.
Day 21Tender red bumps appear on the front of both shins.
Day 23 · todayThe antibiotic ran out yesterday. She is not better. She is worse.

Also in the notes: no travel except the dig · no one at home is sick, not even Leo, who shares her bedroom · nobody in her class is sick except two other science-club kids.

Evidence 3 · Physical exam

Medical Detectives · Case No. 003 · Marisol is a fictional patientCase file · page 1 of 3
Medical Detectives · Case File No. 003Patient file · Marisol T.
Evidence 4–6

Evidence 4 · Who got sick? the science-club sign-in sheet

GroupWhere they were on Day 0PeopleSick now
Pit crew, no maskDigging in the main pit, in the wind and dust33
Pit crew, dust maskSam dug in the same pit but wore a dust mask all day10
Sifting crewScreening dirt under the shade tent, upwind of the pit60
AdultsThe bus and the snack table20
Families of the 3 sick kidsAt home with them: same houses, same bedrooms90

Lunch: all 12 people at the dig ate the same sandwiches and drank bottled water.

Evidence 5 · Lab results read each sample against its controls

Rapid flu testnose swab
Positive controlNegative controlMarisol
Rapid strep testthroat swab
Positive controlNegative controlMarisol
Sputum culture on agarafter 48 hours
Positive control
known bacteriaNegative control
nothing addedMarisol's sputum

Evidence 6 · Treatment so far and her records

The antibiotic

Amoxicillin, an antibiotic, for 10 days (Day 13 to Day 22). Mom checked off every dose:
✓✓✓✓✓✓✓✓✓✓
Result: no better. Worse.

Immunization record

MMR vaccine (measles, mumps, rubella), dose 1age 1 ✓
MMR vaccine, dose 2age 4 ✓
Flu shotnot yet this year

Two MMR doses protect about 97 of every 100 people from measles.

Pepper the kitten

Adopted on Day 9. The vet checked her: healthy, with no bald or scaly patches. Leo holds Pepper every day, and Leo has no rash.
Medical Detectives · Case No. 003 · Marisol is a fictional patientCase file · page 2 of 3
Medical Detectives · Case File No. 003The six suspect files
Suspects
Suspect 1 · virus

Influenza virus

The flu
Incubation
1 to 4 days
Symptoms
Starts suddenly. Fever or chills, cough, sore throat, runny or stuffy nose, muscle aches, headache, tiredness.
Spread
Person to person: droplets from coughs and sneezes, shared drinks, surfaces.
Treatment
Rest and fluids. An antiviral if caught early.
Suspect 2 · virus

Measles virus

Measles
Incubation
10 to 14 days
Symptoms
High fever, cough, runny nose, red watery eyes, tiny white spots inside the mouth, then a flat red rash that starts on the face and spreads down to the feet.
Spread
Person to person. Extremely contagious: it can hang in the air of a room for 2 hours.
Treatment
Rest, fluids, fever control. Prevented by the MMR vaccine.
Suspect 3 · bacterium

Streptococcus pneumoniae

Pneumococcal pneumonia
Incubation
1 to 3 days
Symptoms
Fever, chills, cough, fast or hard breathing, chest pain, weakness, tiredness.
Spread
Person to person: droplets from an infected person's coughs and sneezes.
Treatment
Antibiotics.
Suspect 4 · bacterium

Group A Streptococcus

Strep throat and scarlet fever
Incubation
2 to 5 days
Symptoms
Throat pain, hard to swallow, red swollen tonsils with white spots, swollen neck glands, fever, headache, a red rash that feels like sandpaper.
Spread
Person to person: saliva, coughs, sneezes, shared food and drinks.
Treatment
Antibiotics.
Suspect 5 · fungus

Trichophyton

Ringworm
Incubation
4 to 14 days
Symptoms
Itchy, red, scaly, cracked skin in a ring-shaped rash. Sometimes blisters or patches of hair loss. It stays on the skin: no cough, no fever.
Spread
Touching an infected person or animal (cats, dogs), or shared towels and clothes.
Treatment
Antifungal cream.
Suspect 6 · fungus

Coccidioides

Valley fever
Incubation
1 to 3 weeks
Symptoms
Tiredness, cough, fever, chest pain, headache, night sweats, muscle or joint aches, a rash on the upper body or legs.
Spread
Lives in dry soil in parts of California and the Southwest. Digging or wind throws its spores into the air, and people breathe them in. Not spread from person to person.
Treatment
Rest. Antifungal medicine for serious cases.
Medical Detectives · Case No. 003 · suspect facts follow the PLTW Disease Dictionary and CDCCase file · page 3 of 3