usmleasr
Forum Guru
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A 30 year old woman is admitted to the hospital with a fever. She was recently diagnosed with acute leukemia and finished a course of chemotherapy last week. As a result of her treatment she now has essentially no white blood cells. As part of her workup you perform 2 blood cultures, a sputum culture, a urine culture, and you obtain a chest x-ray. Of all of these tests, the only positive result is one blood culture growing a gram positive bacillus. This bacillus is:
A. The most likely cause of the fever
B. Most likely a contaminant
C. An indication that the patient has meningitis
D. Most likely an organism she acquired from the hands of a health care provider the last time she was in the hospital
explain the ans
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| peekay
Forum Guru
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MOST LIKELY A CONTAMINAT FROM IMPROPER CLEANING OF CULTURE SITE.MAJORITY OF NORMAL SKIN FLORA ARE G.PO. IN ADDITION IF THERE IS NO WBC THAN SEPTICEMIA IS RULED OUT.
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| asmi
Forum Hero
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agree with B...could be diptheroids
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| usmleasr
Forum Guru
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yes u both r correct 
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| dr.shar
Forum Elite
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most common cause of fever in neutropinia patients is septicemia, it thik the bacteria might be causing fever, can yu please explain
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| usmleasr
Forum Guru
Topics: 105
Posts: 970
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list the gram positive bacilli first...so we will get an idea...i was also confused at first...then i agreed to ans
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| asmi
Forum Hero
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and more over a single organism in culture plate is always regarded as nonsignificant
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