USMLE · Question #621
A 50-year-old male who is a known alcoholic is brought to the emergency department by police. He complains of a productive cough with thick, bloody sputum. Vitals reveal a temperature of 38°C (100.4 °
The correct answer is A. gram-negative oxidase-negative bacillus. This patient who is an alcoholic with a productive cough with "currant jelly sputum" and lobar consolidation most likely has pneumonia caused by Klebsiella pneumoniae. Klebsiella pneumoniae is a gram-negative, oxidase-negative rod which is part of the intestinal flora. It produce
Question
A 50-year-old male who is a known alcoholic is brought to the emergency department by police. He complains of a productive cough with thick, bloody sputum. Vitals reveal a temperature of 38°C (100.4 °F). Physical examination reveals dullness to percussion, increased tactile fremitus and decreased breath sounds over the right lung fields. A chest radiograph is obtained which reveals consolidation in the right upper lobe. The most likely cause of these findings is a
Options
- Agram-negative oxidase-negative bacillus
- Bgram-positive oxidase-positive bacillus
- Cgram-negative pleomorphic bacillus
- Dgram-positive catalase-negative coccus
- Egram-positive catalase-positive coccus
How the community answered
(31 responses)- A84% (26)
- B10% (3)
- C3% (1)
- E3% (1)
Explanation
This patient who is an alcoholic with a productive cough with "currant jelly sputum" and lobar consolidation most likely has pneumonia caused by Klebsiella pneumoniae. Klebsiella pneumoniae is a gram-negative, oxidase-negative rod which is part of the intestinal flora. It produces mucoid colonies due to polysaccharide capsules and causes aspiration pneumonia in diabetics and alcoholics. It is also associated with multidrug resistance. Treatment is with a third- generation cephalosporin with or without an aminoglycoside.
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