CASE HISTORY
Cindy,a 38-year-old woman with no significant previous medical history,came to the emergency department complaining of a mild sore throat persisting for three days.Her symptoms included arthralgia (joint pain),myalgia (muscle pain),and low-grade fever.The day before,she had a severe headache with neck stiffness,nausea,and vomiting.She was not taking medications,had no known drug allergies,and did not smoke.Cindy lived with her husband and two children,all of whom were well.Cerebrospinal fluid (CSF)was collected from a spinal tap and sent to the diagnostic laboratory.The CSF appeared cloudy (it should be clear)and contained 871 white blood cells (mainly neutrophils)per microliter (normal is 0-10/ml);the glucose level was 1 mg/dl (normal is 50-80 mg/dl);and the total protein level was 417 mg/dl (normal is under 45 mg/dl).Gram stain of a CSF smear revealed Gram-negative rods.The sample was streaked onto chocolate,blood,and Hektoen agars for microbial identification.
Why was the sample taken from Cindy streaked onto three separate agar plates? Describe the use of selective and differential media in the identification of pathogens-how might the growth on three media differ,and how will that alter the next steps in identifying a pathogen?

Question

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The Answer of CASE HISTORY
Cindy,a 38-year-old woman with no significant previous medical history,came to the emergency department complaining of a mild sore throat persisting for three days.Her symptoms included arthralgia (joint pain),myalgia (muscle pain),and low-grade fever.The day before,she had a severe headache with neck stiffness,nausea,and vomiting.She was not taking medications,had no known drug allergies,and did not smoke.Cindy lived with her husband and two children,all of whom were well.Cerebrospinal fluid (CSF)was collected from a spinal tap and sent to the diagnostic laboratory.The CSF appeared cloudy (it should be clear)and contained 871 white blood cells (mainly neutrophils)per microliter (normal is 0-10/ml);the glucose level was 1 mg/dl (normal is 50-80 mg/dl);and the total protein level was 417 mg/dl (normal is under 45 mg/dl).Gram stain of a CSF smear revealed Gram-negative rods.The sample was streaked onto chocolate,blood,and Hektoen agars for microbial identification.
Why was the sample taken from Cindy streaked onto three separate agar plates? Describe the use of selective and differential media in the identification of pathogens-how might the growth on three media differ,and how will that alter the next steps in identifying a pathogen?

CASE HISTORY Cindy,a 38-Year-Old Woman with No Significant Previous Medical History,came to History,came