Lifelines Online Summer 2000

Faculty Workshop

 Author Mahmoud Bishr
 Case Study The ER Picnic


Do you know what happened in our town last week?

Last Sunday, some people from our community met at the park to discuss an important issue about the city drinking water and later had a picnic by the lake. Everybody, including the flies, had a good, good time. It turned out that nearly everyone who was around during the picnic had to be rushed to the hospital sometime during the next week.

The children had so much fun swimming and playing with turtles and frogs. The food was enjoyed by most, even though it was left out for some time without cooling. There were eggs, olives, ham, bread, fish, beef slices with gravy and even some canned tuna. Fresh fish caught that day at the lake was fried southern style and proved to be a popular dish.

Later that night, John, Cindy and Mathew complained of nausea, vomiting, abdominal cramps and diarrhea. In addition to those symptoms, Chris and Pat suffered from double vision, paralysis and difficulty in breathing.

In the next two days, Morgan, Megan and Elaine suffered from low grade fever, dehydration and bloody diarrhea. Muo was also diagnosed with pus and mucus in his stool.

After five days, Kory complained of abdominal pain, diarrhea, malaise, nausea and vomiting.

One week later, Macun, a seven year-old child, who was visiting his uncle and swam in the lake, died. His main symptom was severe headache. Janet, his aunt who is pregnant, also suffered from severe headache.


Students, Nursing and Lab Tech taking Microbiology course. You have been called to help.

1) Read the case and identify what disease(s) and possible microorganism(s) were involved.

2) What sample(s) should be collected and when?

3) How will you proceed to isolate and identify the causative agent(s).

4) What media will you be using to isolate the organisms?

5) Which stains and staining techniques will you use?

6) List possible biochemical testing you would use to help identify the organism(s).

7) What special incubation and temperature conditions will be needed.

8) What characteristics/results allow for the confirmation of the organism(s).

9) The Health Department asked for a microorganism count in different samples. How will you comply?

Getting Started 

Scenario Analysis

1. What is the case about?
2. What do you already know?
3. What do you want to know?
4. How will you proceed to find the answers to your questions?

Problem Solving 

The students are required to work on this in groups of not more that 3 students.

1) Make use the information of the case history and be able to analyze it, with a decision about the diseases(s) likely to be involved.

2) Decide what sample(s) should be collected, when sample(s) should be collected, and how to handle the sample(s).

3) Proceed with the samples the right way to reach an accurate diagnosis.

4) Identify biochemical tests performed in order to reach final identification of the microorganism (s).

5) Complete laboratory reports showing all the steps so others could duplicate them.

6) Describe the technique to perform the viable cell count.


Any Clinical Microbiology or Infectious Disease text Some web sites will be provided by instructor.


A written report on the case that shows work in the form of an actual lab analysis.

Each student will work with an unknown in lab as well.

Assessment and Evaluation 

The students will be assessed based on their conclusions as well as how they approached the case and the labs.

The students will be evaluated based on:

1- The conclusions based on the symptoms about the diseases and the causative microorganism.

2- The strategy of collecting and handling the samples.

3- How to process the samples in the laboratory, how to make viable cell count and the results of the viable cell count.

4- Identification of the laboratory steps used in order to reach an accurate identification of the organism(s).

5- Confirmation of the identified microorganism.


Each group will asked to present an oral presentation of their conclusions.