A 61-year-old woman on mechanical ventilation for 8 days develops fever (38.9°C), tachycardia (HR 112), and purulent sputum. Chest X-ray shows new bilateral infiltrates. Sputum culture grows a non-lactose fermenting, oxidase-positive gram-negative rod. The organism produces a toxin inactivating elongation factor 2 through ADP-ribosylation. Blood cultures remain negative. The patient has received appropriate empiric antibiotics for 48 hours without clinical improvement. Which organism is most likely responsible?
- A)Bordetella pertussis
- B)Neisseria meningitidis
- C)Pseudomonas aeruginosaGABARITO
- D)Escherichia coli
- E)Vibrio cholerae
Explicação
Pseudomonas aeruginosa produces exotoxin A, which ADP ribosylates elongation factor 2 and inhibits protein synthesis. The ventilator associated pneumonia and non lactose fermenting oxidase positive gram negative rod strongly support Pseudomonas. Ver explicação completa e trilha adaptativa →