A 45-year-old man with poorly controlled type 2 diabetes mellitus presents to the emergency department with a 3-day history of fever, productive cough with purulent sputum, and progressive dyspnea. He reports feeling confused since this morning. Vital signs show temperature 39.2°C, heart rate 118/min, respiratory rate 28/min, and blood pressure 95/62 mmHg. Physical examination reveals crackles in bilateral lower lung fields. Laboratory studies reveal blood glucose 485 mg/dL, serum creatinine 2.1 mg/dL (baseline 0.9), and white blood cell count 16,500/μL. Chest radiograph demonstrates bilateral consolidative infiltrates with air bronchograms. Sputum culture yields mucoid, gram-negative rods that are oxidase-negative and ferment lactose. The organism forms a thick, gelatinous colony on culture media. Which of the following organisms is most likely responsible for this patient's pneumonia?
- A)Pseudomonas aeruginosa
- B)Serratia marcescens
- C)Proteus mirabilis
- D)Klebsiella pneumoniaeGABARITO
- E)Enterobacter cloacae
Explicação
Klebsiella pneumoniae is a gram-negative, mucoid, lactose-fermenting rod with a thick polysaccharide capsule that produces a characteristic gelatinous, mucoid appearance on culture. It is a well-known cause of community-acquired pneumonia (CAP) and is particul... Ver explicação completa e trilha adaptativa →