A 35-Year-Old Man Comes to the Office Due to 3

question 220

Multiple Choice

A 35-year-old man comes to the office due to 3 months of progressive swelling under his left jaw.  The swelling spontaneously opened and drained pus a month ago but has not improved or resolved.  The patient has no medical conditions other than dental caries; he had a tooth extracted prior to symptom onset.  Physical examination shows an indurated, nontender mass in the left submandibular area with a small opening on the overlying skin.  Gentle pressure on the mass yields thick pus containing sand/grain-like particles.  The microbial pathogen with which of the following characteristics is the most likely cause of this patient's condition?

• A)Bipolar-staining, gram-negative bacilli
• B)Coagulase-producing, gram-positive cocci
• C)Conidia-forming, dimorphic fungus
• D)Filamentous, branching, gram-positive bacilli
• E)Oxidase-positive, gram-negative bacilli

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