new_n_lost
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A 60-year-old alcoholic smoker abruptly develops high fever, shakes, a severe headache, and muscle pain. He initially has a dry, insignificant cough, but over the next few days he develops marked shortness of breath requiring assisted ventilation. Chest x-ray demonstrates homogeneous radiographic shadowing that initially involves the left lower lobe but continues to spread until both lungs are extensively involved.
Culture of bronchoalveolar lavage fluid on buffered charcoal yeast extract (BCYE) demonstrates a coccobacillary pathogen. Which of the following is the most likely causative organism?
A. Legionella pneumophila
B. Listeria monocytogenes
C. Spirillium minus
D. Staphylococcus aureus
E. Streptococcus pneumoniae
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| jole
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A?
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| chemamr
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agree
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| mytime
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yEAHHHHHHHHHHH A...needs  and cysteine.
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| new_n_lost
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| new_n_lost
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The correct answer is A.
The patient has a severe, potentially fatal, pneumonia with prominent systemic symptoms. Culture on BCYE is the specific clue that the organism is Legionella pneumophila. The disease is respiratory Legionellosis, also known as Legionnaire's disease, because the disease was first described when it occurred in epidemic form following an American Legion convention at a Philadelphia hotel. Patients tend to be older (40-70 years old) and may have risk factors including cigarette use, alcoholism, diabetes, chronic illness, or immunosuppressive therapy.
Listeria monocytogenes (choice B) causes listeriosis and is not a notable cause of pneumonia.
Spirillium minus (choice C) is a cause of rat-bite fever and is not a notable cause of pneumonia.
Staphylococcus aureus (choice D) can cause pneumonia, but is easily cultured on routine media.
Streptococcus pneumoniae (choice E) can cause pneumonia, but is easily cultured on routine media.
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| keepgoing
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resides in ACs also in ICU setting whn pat. is on uncleaned ventilators...
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| tanmaynator
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legionella pneumophila.. yeah i think so too..
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