phuluong2k
Forum Fanatic
Topics: 714
Posts: 2,008
|
A 74-year-old woman, who has been followed for the past 25 years for chronic obstructive pulmonary disease (COPD) presents complaining of 48 hours of temperatures to 38.6 C (101.4 F) and worsening shortness of breath. She has a chronic productive cough, which has become more copious. On physical examination, she has rhonchi and increased fremitus in the posterior mid-lung field. A Gram's stain reveals many epithelial cells and multiple gram-positive and gram-negative organisms; no neutrophils are seen. Which of the following is the most likely organism causing the symptoms?
A. Escherichia coli
B. Haemophilus influenzae
C. Klebsiella pneumoniae
D. Mycobacterium tuberculosis
E. Mycoplasma pneumonia
|
| kabu
Forum Senior
Topics: 19
Posts: 105
|
B.
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
B. Haemophilus influenzae
___________________
Sincerity and hard work are the keys to success!
|
| ibraheem
Forum Junior
Topics: 5
Posts: 40
|
B. Haemophilus influenzae.
|
| phuluong2k
Forum Fanatic
Topics: 714
Posts: 2,008
|
Right
Any one can explain this ?
A Gram's stain reveals many epithelial cells and multiple gram-positive and gram-negative organisms; no neutrophils are seen
|
| kabu
Forum Senior
Topics: 19
Posts: 105
|
H infl. tend to be pleomorphic and are notorious for variable gram staining. So, in my mind when i find older pts with hx of chr resp sx and variable staining - its more than likely H. infl.
Of course there are no hard and fast rules and its often a choice becos the others as in above q don't fit the picture. I hope this helps - and please comment - anyone else?
|
| nisha
lil monkey
Topics: 146
Posts: 919
|
and remember that strept pnuemoniae and H. influenza infections are more common in COPD anyway
___________________
IM resident
|
|
| |
| | | | | | | |
