This 53-years-old man with a past medical history of non-insulin dependent diabe

Question

This 53-years-old man with a past medical history of non-insulin dependent diabetes mellitus and hypertension was in his usual state of health until 4 days prior to admission, when he developed fatigue, fever, chills and a cough occasionally productive of green sputum. Over the two days prior to admission, he had drenching sweats, increasing dyspnea, and left-sided pleuritic chest pain. The patient had smoked two packs of cigarettes a day for 40 years. His physical examination was notable for an increased respiratory rate of 22 per minute, and crackles were heard over the right middle, left middle, and lower lung fields. A chest radiograph demonstrated right lower lobe, left lingular, and left lower lobe infiltrations. The blood sample cultured on blood agar is on your bench

Explanation / Answer

According to the information, the patient is a chronic smoker with diabetes mellitus pathology.

This suggests that a blood culture would fail to recognize any acute infections and only chronic inflammation would be easily available in the reports. Further, the total hemtology count of the patient too shall be disturbed due to local inflammation. Here, use of antibiotics would also suppress the extent and correctness of the blood culture since general consumption of antibiotics affects the whole body, not only the lungs. Finally, the non-insulin dependency of the patient would further enhance any septic conditions but would not suppress the results.

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