This 48 year old man had a long history of alcoholism and was admitted to the in

Question

This 48 year old man had a long history of alcoholism and was admitted to the intensive care unit with profound hypotension and gastrointestinal bleeding. He was intubated and given intravenous fluids and transfused with packet red blood cells. He remained intubated and ventilator dependent for several weeks. He developed fevers and was treated with broad-spectrum antibiotics. Culture of his tracheal aspirate initially showed Staphylococcus aureus. After further antibiotic therapy, a gram stain of his tracheal aspirate showed gram negative rods. His chest radiograph demonstrated an infiltrate and changes consistent with multiple small abscesses. Culture of the tracheal aspirate yielded heavy growth of an oxidase-positive, non-lactose fermenting, gram negative rod that produced a blue-green water soluble pigment. The causative agent of this infection i

Explanation / Answer

The causative agent of this infection is Pseudomonas aeruginosa.

The patient's clinical, x-ray, and laboratory findings are consistent with the diagnosis of a nosocomial Pseudomonas aeruginosa infection. Pseudomonas is most often transmitted through respirations because it is a water-loving bacteria.

Azlocillin is one of several penicillins that are classified as antipseudomonal penicillins.

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