A 3-Year-Old Boy with Sickle Cell Anemia Is Brought to the Emergency

question 448

Multiple Choice

A 3-year-old boy with sickle cell anemia is brought to the emergency department due to fever.  He has chills but no bone pain, cough, or difficulty breathing.  The patient's medical history includes hospitalization as an infant for dactylitis and again last summer for splenic sequestration crisis.  Other than ibuprofen and acetaminophen for fever and pain, he takes no medications regularly and his vaccinations are current.  Temperature is 39.5 C (103.2 F) , blood pressure is 78/40 mm Hg, pulse is 140/min, and respiratory rate is 22/min.  Physical examination shows a lethargic boy with mild pallor.  Laboratory results are as follows: Blood culture is pending.  Which of the following organisms is the most likely cause of this patient's condition?

• A)Haemophilus influenzae type B
• B)Neisseria meningitidis
• C)Pseudomonas aeruginosa
• D)Salmonella enteritidis
• E)Staphylococcus aureus
• F)Streptococcus pneumoniae

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