Question

• 2 yr old child with UTI 2 weeks prior to hospital admission. • High fever and lethargy • Physical exam: clear chest, exudative pharyngitis, cervical lymph nodes enlarged • Throat culture taken, penicillin is started • Throat culture negative for GAS

• Child's condition worsened, - increasing lethargy and fever • She develops respiratory distress • Admitted to the hospital Your patient: • On examination in emergency, the child was seen to have a yellowish-gray thick membrane in the back of the throat which bled when the doctor scraped it and tried to remove it. • Childs immunization history: no MMRV, no DPT (parents did not believe in vaccinations)
The child was admitted to hospital and treatment started. Special cultures of the pharynx were taken, and the suspected pathogen grew. On Gram stain it was Gram positive bacilli without spores. Which is the likely pathogen?
A. Corynebacterium diphtheriae
B. Bordetella pertussis
C. Mycobacterium tuberculosis
D. Haemophilus influenzae
E. Streptococcus pneumoniae

Answer 1

The likely pathogen causing the symptoms and presenting with a yellowish-gray thick membrane in the back of the throat is A. Corynebacterium diphtheriae, the causative agent of diphtheria.

Step-by-step explanation:

Based on the clinical presentation and findings such as a yellowish-gray thick membrane in the back of the throat which bled when scrapped, along with the results from the special cultures revealing Gram positive bacilli without spores, the likely pathogen is A. Corynebacterium diphtheriae. This bacterium is the causative agent of diphtheria, which is characterized by the formation of a pseudomembrane, high fever, and lethargy, especially in an unvaccinated child.