A 64-Year-Old Man Comes to the Office Due to Several

question 137

Multiple Choice

A 64-year-old man comes to the office due to several days of low-grade fever and productive cough.  He has smoked a pack of cigarettes daily for 30 years and has been hospitalized several times for respiratory infections.  Temperature is 37.2 C (99 F) , blood pressure is 130/70 mm Hg, pulse is 82/min, and respirations are 14/min.  Pulse oximetry shows 98% on ambient air.  Lung auscultation reveals rhonchi that clear with coughing.  Sputum cultures in specialized media grow round-to-oval, budding yeast, which form germ tubes when incubated at 37 C in serum.  Which of the following best explains the presence of the organism in this patient's sputum sample?

• A)Colonization of a preexisting lung cavity
• B)Contamination by normal oral flora
• C)Embolization of infectious microthrombi
• D)Lung infection from inhaled microconidia
• E)Proliferation of previously latent organism