A 7-Year-Old Boy Is Brought to the Emergency Department Due

question 1254

Multiple Choice

A 7-year-old boy is brought to the emergency department due to fever and right leg pain.  The patient's symptoms began 3 days ago, when his parents noticed him limping.  He had mild right lower leg pain at that time, but subsequently developed fever, fatigue, and decreased appetite 2 days ago.  The patient's pain is currently 7 on a scale of 0-10 in severity, is nonradiating, and is unrelieved by ibuprofen, heat, or rest.  He has no history of trauma and is otherwise healthy.  Immunizations are up to date.  The patient's second cousin has sickle cell disease.  Current temperature is 39.4 C (102.9 F) , blood pressure is 100/70 mm Hg, pulse is 138/min, and respirations are 22/min.  Examination of the right leg shows bony point tenderness, erythema, and warmth over the proximal tibia.  Blood is drawn for culture.  Which of the following organisms will most likely be isolated from this patient's blood?

• A)Escherichia coli
• B)Pseudomonas aeruginosa
• C)Salmonella species
• D)Staphylococcus aureus
• E)Staphylococcus epidermidis
• F)Streptococcus agalactiae
• G)Streptococcus pyogenes

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