October 27, 2010

Q&A: Likely Pathogen Of Chest Infection

Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia. CAP is a common and potentially serious illness. It is associated with considerable morbidity and mortality, particularly in older adult patients and those with significant comorbidities.

This article is for Medical Students & Professionals
This is a Question & Answer revision article designed for medical students and professionals preparing for the PLAB, MRCP or USMLE examinations. They are based on actual questions from these examinations. You may find the Pneumonia article more useful, or one of our many articles on Diseases & Conditions, Medical Syndromes, Health & Wellness or Home Remedies.
In this article:
Diagnosis of community-acquired pneumonia
MCQ: clinical scenario
MCQ: answer
MCQ: explanation

Diagnosis of community-acquired pneumonia

The diagnosis of community-acquired pneumonia (CAP) generally requires the demonstration of an infiltrate on chest radiograph in a patient with a clinically compatible syndrome (eg, fever, dyspnea, cough, and sputum production).

Microbiologic testing is reserved for hospitalized patients and for selected outpatients in whom test results would change management.

MCQ: clinical scenario

A 25 year old man has a three day history of shivering, general malaise and productive cough. The x-ray shows right lower lobe consolidation.

What is the most likely pathogen?

a) Coxiella burnetii
b) Escherichia coli (Gram -ve)
c) Haemophilus influenzae
d) Strep pneumococcus
e) Staphylococcus aureus

MCQ questions & answers on medicalnotes.info

MCQ: answer

The correct answer is D

MCQ: explanation

Pneumococcal pneumonia most commonly presents as a segmental or lobar alveolar consolidation. Pleural effusion can be found in 20-60% of cases. Cavitation is very uncommon with pneumococcal infection.

Reference(s)
1). UpTodate: Diagnostic approach to community-acquired pneumonia in adults. Available online: https://www.uptodate.com/contents/diagnostic-approach-to-community-acquired-pneumonia-in-adults

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