A 52-year-old transient male comes in ER of a large county hospital. He is pale, coughing and complains of chest pains. On physical examination, it is determined that he is both underweight and undernourished. He has the rapid respiratory rate of 38/minute, a temperature of 102.1oF and smells of the alcohol. When the doctor listened to his lungs, rales were apparent. A chest x-ray revealed widespread consolidation in lower left lobe of his lungs. This was accompanied by the cavity formation.
The patient produced bloody sputum which revealed the encapsulated gram-negative rods and large number of the neutrophils. Cultures of sputum for Streptococcus pneumoniae, Legionella pneumoniae, and Mycoplasma pneumoniae were all negative. Despite being given high doses of the broad-spectrum antibiotics, the patient’s condition deteriorated. He was intubated and put on ventilator. Unfortunately, the patient became septic and died shortly after this.
What is probable causative organism in this case and how did you come to this conclusion?
Why did antibiotic therapy be unsuccessful in this case?
Can this disease be transmitted from the person-to-person? If not, how is it transmitted?
Do other species of this organism cause respiratory tract disease?
How can this organism be differentiated from the other members of Enterobacteriaceae?
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