Musuq
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A 23-year-old woman has a fever and a cough productive of rust-colored sputum. A gram-positive coccus isolated from the sputum is sensitive to optochin. Which of the following is the most likely causal organism?
A) Enterococcus faecium
B) Streptococcus agalactiae (group B)
C) Streptococcus pyogenes (group A)
D) Streptococcus pneumoniae
E) Streptococcus sanguis
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| docsrinu
Forum Elite
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D
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| sosikan
Forum Junior
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yes d
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| MRMAVERICK
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D
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| mousa
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:nod .....EASY QS
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| keepgoing
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yep Streptococcus pneumoniae
clues--resp tract inf
--rusty sputum
--optochin sensitive
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| PatriciaLim
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D rusty
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| disha
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d
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| Cedrick
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Streptococcus pneumoniae
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| docarchana
Forum Guru
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its a lancet shaped diplococcus.
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| bactitech
Forum Elite
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Streptococcus pneumoniae is one of the most common and most dangerous causes of bacterial pneumonia.
http://www.pubmedcentral.nih.gov/articlerender.fc...
"Streptococcus pneumoniae (pneumococci) is a leading cause of pneumonia, sepsis, and meningitis among adults. Mortality associated with invasive disease remains high at 5–35% depending on site of infection, age and comorbidity [1-4]."
The elderly are at high risk. I remember going to a conference in the early 90's, right when biaxin and Azithromycin were coming on the market. A pulmonary doc from U. of Michigan gently but emphatically raled on the primary care physicians in the audience. He told them that they must take pneumonia in the older adult very seriously and not mess around and think that they had Mycoplasma pneumonia and just treat with erythromycin (probably more common then than now with the high usage of Azith). These patients would then end up on his doorstep in the ER at U of M near death from undertreated pneumonia. He said that this bug must be hit heavy and hard right away in order to avoid death, especially in the elderly. Back then S. pneumoniae was still pretty universally sensitive to penicillin. That has changed in the last 15 years, and we see quite a few that are resistant now. Back in the 70's we never even performed antibiotic susceptibility testing on this organism, as it was believed (and was back then) to be universally sensitive to penicillin. Pen resistant strains started showing up in the early 80's, I believe.
I'm not sure what the standard treatment protocol is nowadays for bacterial pneumonia from S. pneumo, but I'm certain that it has changed. I have personally known two people that had it and recovered. One was in her 40's when it landed her in ICU and she thought she was going to die at one point. She said it took her lungs over six months to recover.
Another caught it early, but did end up hospitalized. It took her a month to recuperate at home to the point she wasn't breathless and tired from the least exertion.
This bug is nothing to mess with.
___________________
Clinical Microbiology since 1974
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