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2)What are the probable etiologic agent during this time?

2)What are the probable etiologic agent during this time?. BACTERIAL Streptococcus pneumoniae The pneumococci ( S pneumoniae ) are gram-positive diplococci , often lancet-shaped or arranged in chains, possessing a capsule of polysaccharide that permits typing with specific antisera .

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2)What are the probable etiologic agent during this time?

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  1. 2)What are the probable etiologic agent during this time?

  2. BACTERIAL • Streptococcus pneumoniae • The pneumococci (S pneumoniae) are gram-positive diplococci, often lancet-shaped or arranged in chains, possessing a capsule of polysaccharide that permits typing with specific antisera. • Pneumococci are readily lysed by surface-active agents such as bile salts. Surface-active agents probably remove or inactivate the inhibitors of cell wall autolysins. Pneumococci are normal inhabitants of the upper respiratory tract of 5–40% of humans and can cause pneumonia, sinusitis, otitis, bronchitis, bacteremia, meningitis, and other infectious processes.

  3. Also consider… • Mycoplasmapneumoniae • Staphylococcus pneumoniae • Legionellapneumophila • Chlamydia psittaci • Mycobacterium tuberculosis

  4. FUNGAL • Histoplasmacapsulatum • Coccidioidesimmitis • Blastomycesdermatitidis • Candida species • Aspergillus species • Cryptococcus neoformans

  5. VIRAL • Haemophilusinfluenzae • Respiratory syncytial virus (RSV)

  6. What other laboratory exams would you request at this time to support your diagnosis? • Sputum gram culture • determine if pneumonia is present • Purified Protein Derivative (PPD) tuberculin test • Low sensitivity and specificity • Sputum Acid Fast Bacilli (AFB) Smear • Light microscopy of specimen (expectorated sputum) stained with Kinyoun or Ziehl-Neelsen basic fuschin dyes • in the morning for 3 consecutive days • Mycobacterial culture • Specimens inoculated onto egg or agar based medium • 3 consecutive early morning sputum specimen

  7. Intraperitoneal Injection of Sputum into Mice • Animals die in 18–48 hours; heart blood gives pure culture of pneumococci. This form of culture for pneumococci is very sensitive but seldom used because of the need to maintain a mouse colony.

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