A 55-Year-Old Man Comes to the Emergency Department with Fever

question 226

Multiple Choice

A 55-year-old man comes to the emergency department with fever and chills.  He has a history of acute myeloid leukemia for which he is receiving chemotherapy.  His temperature is 38.3 C (101 F) , blood pressure is 90/50 mm Hg, pulse is 124/min, and respirations are 22/min.  Physical examination is notable for multiple skin patches with necrotic centers and occasional ulcerations, as shown in the image below. Laboratory results are as follows: Blood cultures are drawn.  Which of the following organisms is most likely responsible for this patient's symptoms?

• A)Escherichia coli
• B)Haemophilus influenzae
• C)Klebsiella pneumoniae
• D)Pseudomonas aeruginosa
• E)Streptococcus pneumoniae
• F)Streptococcus pyogenes

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