Which of the following infectious agents is most likely to cause her pulmonary disease?
A 70-year-old woman has been at an extended care facility for the past two years because of her increasing inability to attend to activities of daily living. She can no longer recognize family members. She has no movement disorder, but is lethargic and spends most of her days in a wheelchair or in bed. She develops an acute febrile illness and is noted to be coughing up increasing quantities of yellowish sputum. Her temperature is 38.2 C. A chest radiograph shows infiltrates that nearly fill the left lower lobe. Her family elects not to treat her acute illness, and she dies 4 days later. At autopsy, there is an extensive consolidation of the left lower lobe, with numerous neutrophils within alveoli.
A. Pneumocystis carinii (jiroveci) B. Listeria monocytogenes C. Cryptococcus neoformans D. Mycobacterium tuberculosis E. Legionella pneumophila F. Staphylococcus aureus G. Streptococcus pneumonia H. Influenza A virus
Streptococcus pneumoniae -(g) correct. she has a lobar pneumonia, which is most often a community aquired pneumonia (the nursing home counts as a community venue), following a debilitating course of alzheimer disease. the most common organism is streptococcus pneumoniae (pneumococcus).(b) incorrect. listeriosis is infrequent. some cases occur in immune compromised persons. it can be a congenital infection.(f) incorrect. s. aureus is more likely to be a nosocomial infection and more likely to produce a bronchopneumonia with patchy infiltrates.