A 65 vear oid man presents to the hospital with a one week history of malaise, headache, fever, and chilis. He is admitted and over the next week his disease progressed with a worsening cough and shortness of breath. His physical exam was benign except for pulmonary compromise. The patient is current on all of their vaccinations and has no recent travel history. A chestradiograph showed multilobar infiltrates. Other sighificant laboratory findings include an elevated white blood cell count with increased polymorphonuclearneutrophils. Because the patient had a prior history of drug abuse and alcoholism, a toxicology screen and HIV serology were performed. Both were negative. A bronchoscopy was performed, with a bronchoalveolar lavage (BAL) showing many white blood cell5, but no organisms. Calcofluor white stains for fungi and direct fluorescent-antibody stain (DFA) for Pneumocystis were aiso negative. Routine bacterial culture of the BAL was negative. Question 1 1 pts Wny was the BAL routine bacterial culture negative? The pasients condtion is not due to a microorganism The pathogen is not a bacteniuin The pothosen a not present in BAL. Poutine bacteriat culfure was not surhcient to recover the puthogen Question 2 1 pts Gased on the patient shistory and condition, what teating should be pertormed next? Bit, pultive for Legionella An organism was recovered only on buffered charcoal yeast extract agar. Based on this information, what is the most likely pathogen? B. pertussis Lpneumophila H. influenzae Brucella spp: Question 4 The organism was most likely transmitted by: Handing of inimul prodicts Reipiratory droblets from an infected persen. Inhulation of water droplets An arthropod vectar lexin- tick Question 5 1 pts What other testing can be performed to detect this organism in a patient? Uinury ankgen testing Elektain testing Culuie supplementation with cystiane. Wea bienati trest .

1. A 65 vear oid man presents to the hospital with a one week history of malaise, headache, fever,
and chilis. He is admitted and over the next week his disease progressed with a worsening cough
and shortness of breath. His physical exam was benign except for pulmonary compromise. The
patient is current on all of their vaccinations and has no recent travel history. A chestradiograph
showed multilobar infiltrates. Other sighificant laboratory findings include an elevated white
blood cell count with increased polymorphonuclearneutrophils. Because the patient had a prior
history of drug abuse and alcoholism, a toxicology screen and HIV serology were performed.
Both were negative. A bronchoscopy was performed, with a bronchoalveolar lavage (BAL)
showing many white blood cell5, but no organisms. Calcofluor white stains for fungi and direct
fluorescent-antibody stain (DFA) for Pneumocystis were aiso negative. Routine bacterial culture
of the BAL was negative. Question 1 1 pts Wny was the BAL routine bacterial culture negative?
The pasients condtion is not due to a microorganism The pathogen is not a bacteniuin The
pothosen a not present in BAL. Poutine bacteriat culfure was not surhcient to recover the
puthogen Question 2 1 pts Gased on the patient shistory and condition, what teating should be
pertormed next? Bit, pultive for Legionella An organism was recovered only on buffered
charcoal yeast extract agar. Based on this information, what is the most likely pathogen? B.
pertussis Lpneumophila H. influenzae Brucella spp: Question 4 The organism was most likely
transmitted by: Handing of inimul prodicts Reipiratory droblets from an infected persen.
Inhulation of water droplets An arthropod vectar lexin- tick Question 5 1 pts What other testing
can be performed to detect this organism in a patient? Uinury ankgen testing Elektain testing
Culuie supplementation with cystiane. Wea bienati trest