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|MainCategory=Microbiology
|MainCategory=Microbiology
|SubCategory=Infectious Disease
|SubCategory=Infectious Disease
|Prompt=A 75 year old man with history of severe emphysema maintained on home oxygen is admitted to the intensive care unit for desaturation on 100% FiO2. On admission, his heart rate is 133 bpm, blood pressure 80/53 mmHg, and temperature 39.1 C. Despite efforts, the patient dies shortly after admission. Postmortem examination reveals several black necrotic lesions with a surrounding erythematous edge most prominent on the lower extremities. Blood cultures withdrawn on admission, reveal growth of road shaped gram-negative organisms. What is the most likely organism involved in the patient's presentation?
|Prompt=A 75 year old man with history of severe emphysema maintained on home oxygen is admitted to the intensive care unit for desaturation on 100% FiO2. On admission, his heart rate is 133 bpm, blood pressure 80/53 mmHg, and temperature 39.1 C. Despite efforts, the patient dies shortly after admission. Postmortem examination reveals several black necrotic lesions with a surrounding erythematous edge most prominent on the lower extremities. Blood cultures withdrawn on admission, reveal growth of rod shaped gram-negative organisms. What is the most likely organism involved in the patient's presentation?
 
gram negative
|AnswerA=''Escherichia coli''
|AnswerA=''Escherichia coli''
|AnswerAExp=''Escherichia coli'' sepsis is not associated with ecthyema gangrenosum.
|AnswerB=''Klebsiella pneumoniae''
|AnswerB=''Klebsiella pneumoniae''
|AnswerBExp=''Klebsiella pneumoniae'' sepsis is not associated with ecthyema gangrenosum.
|AnswerC=''Citrobacter freundii''
|AnswerC=''Citrobacter freundii''
|AnswerCExp=''Citrobacter freundii'' sepsis is not associated with ecthyema gangrenosum.
|AnswerD=''Pseudomonas aeruginosa''
|AnswerD=''Pseudomonas aeruginosa''
|AnswerDExp=''Pseudomonas aeruginosa'' sepsis is the classical cause for ecthyema gangrenosum.
|AnswerE=''Proteus mirabilis''
|AnswerE=''Proteus mirabilis''
|AnswerEExp=''Proteus mirabilis'' sepsis is not associated with ecthyema gangrenosum.
|RightAnswer=D
|RightAnswer=D
|WBRKeyword=Pseudomonas aeruginosa, ecthyema gangrenosum
|WBRKeyword=Pseudomonas aeruginosa, ecthyema , sepsis
|Approved=No
|Approved=No
}}
}}

Revision as of 02:17, 20 November 2013

 
Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::Infectious Disease
Prompt [[Prompt::A 75 year old man with history of severe emphysema maintained on home oxygen is admitted to the intensive care unit for desaturation on 100% FiO2. On admission, his heart rate is 133 bpm, blood pressure 80/53 mmHg, and temperature 39.1 C. Despite efforts, the patient dies shortly after admission. Postmortem examination reveals several black necrotic lesions with a surrounding erythematous edge most prominent on the lower extremities. Blood cultures withdrawn on admission, reveal growth of rod shaped gram-negative organisms. What is the most likely organism involved in the patient's presentation?]]
Answer A AnswerA::''Escherichia coli''
Answer A Explanation AnswerAExp::''Escherichia coli'' sepsis is not associated with ecthyema gangrenosum.
Answer B AnswerB::''Klebsiella pneumoniae''
Answer B Explanation AnswerBExp::''Klebsiella pneumoniae'' sepsis is not associated with ecthyema gangrenosum.
Answer C AnswerC::''Citrobacter freundii''
Answer C Explanation AnswerCExp::''Citrobacter freundii'' sepsis is not associated with ecthyema gangrenosum.
Answer D AnswerD::''Pseudomonas aeruginosa''
Answer D Explanation AnswerDExp::''Pseudomonas aeruginosa'' sepsis is the classical cause for ecthyema gangrenosum.
Answer E AnswerE::''Proteus mirabilis''
Answer E Explanation AnswerEExp::''Proteus mirabilis'' sepsis is not associated with ecthyema gangrenosum.
Right Answer RightAnswer::D
Explanation [[Explanation::

Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Pseudomonas aeruginosa, WBRKeyword::ecthyema, WBRKeyword::sepsis
Linked Question Linked::
Order in Linked Questions LinkedOrder::