Texts: A 19-year-old male patient with Cystic Fibrosis
presented to the emergency department with a fever, cough, severe
shortness of breath, congestion, and wheezing. The patient had
recently been hospitalized for pulmonary exacerbation and received
care including IV antibiotics and airway clearance with multiple
breathing treatments. The patient has been hospitalized frequently
over the last few months.
Upon admission from the ED, a sputum was collected and
submitted to the lab for culture.
The gram stain shows GNRs.
Based on the information provided, what could a possible
pathogen be?
A smooth, non-wrinkled colony producing a yellow/green
pigment is isolated from the BAP. A non-lactose fermenter is also
noted on the MAC plate. The tech performs a gram stain on the
smooth, yellow/green pigmented colony and confirms a gram-negative
rod. An oxidase test is performed and is positive.
Additional tests were set up and incubated. The
following results were obtained:
Motility: +
Glucose: Oxidize
Maltose: Oxidize
Lactose: Oxidize
Mannitol: Oxidize
Lysine Decarboxylase: +
ONPG: +
Do these results support your original hypothesis? If
not, what organism is suspected?
Why is this organism particularly dangerous in Cystic
Fibrosis patients in regards to the course of
treatment?
What is the most probable way the patient could have
come into contact with the organism?