Part A. A 78-year-old man is brought to the emergency departmentdue to three days of fever, cough, and shortness of breath. Thepatient works on his families farm. Temperature is 39.4 C (103 F),blood pressure is 106/62 mm Hg, pulse is 112/min, and respirationsare 28/min. His fever has not subsided for the past three days.Chest x-ray reveals a left lower lobe consolidation. Sputummicroscopy shows gram-negative spore forming bacteria. Which of thefollowing characteristics are these bacteria likely todemonstrate?
- Optochin resistance
- Facultative intracellular
- Obligate intracellular
- Catalase positivity
- Bacitracin sensitivity
Part B. After answering part a use your knowledge of micro Bioand part A to answer the following: A 46-year-old man is brought tothe emergency department 30 minutes after being found intoxicatedand unconscious in a park. The patient reports a 10-day history offevers, night sweats, weight loss, and productive cough withfoul-smelling sputum. He drinks 1 or 2 pints of vodka daily and hasbeen hospitalized multiple times for intoxication. Temperature is38.9 C (102 F), blood pressure is 110/65 mm Hg, pulse is 102/min,and respirations are 22/min. Lung auscultation reveals coarsecrackles over the right lower lobe. He is found to haveperitonsillar abscess and thrombophlebitis of internal jugularvein. Laboratory results show an elevated leukocyte count. Chestx-ray reveals a cavitary lesion with an air-fluid level in thesuperior segment of the right lower lobe of the lung. Which of thefollowing is the most likely cause of this patient’s lungfindings?
- Oxidase-positive, gram-negative bacilli
- Filamentous, anaerobic, gram-negative bacilli
- Bipolar-staining, gram-negative bacilli
- Coagulase-producing, gram-positive cocci
