achilles
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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
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| Jinx
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b?
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| sachida
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B
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| vinidoc
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no neutrophils therfore not bacterial?
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| MAZI
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no neutrophil and high epithelial cell and multiple organism = inapropriate smear
but because of hx of chronic COPD the most responsible organism is:
pneumococus, H.enfluenza and moraxella catharalis
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| Researchsurvivor
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Why do you think it can not be C = Klebsiella pneumoniae ?
Hey, achilles - what is the official answer of the question?
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| karusmle
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what is the answer achilles????
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| achilles
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sorry for posting the answer late.
the answer is B-hemophilus influenza. mazi gave the explanation. in COPD pt the most common organisms are pneumococcus, h. influenzae, moraxalla cataralis.
researchsurvivor, klebseilla pn. is more common in alcoholics.
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