johndoe3344

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A 74 y/o previously healthy Caucasian male comes to his physician's office complaining of abrupt onset fever, headache, myalgias, malaise, cough and throat pain. His two granddaughters missed several days of school because of similar symptoms. Examination demonstrates mild hyperemia of the throat without any exudate, and the patient is sent home on conservative management. Five days later, he is admitted to the hospital with progressive dyspnea, chest pain, and productive cough. Which of the following pathogens is most likely to be isolated from the patient's sputum?

a) S. aureus
b) S. pneumoniae

Pathoma [page 88, Table 9.2] says that "S. aureus is the most common cause of secondary pneumonia" while UW [QID 1666] says that "In order, the pathogens most often responsible for secondary bacterial pneumonia are S. pneumoniae, S. aureus, and H. flu"

Ideas?
 

MrBeauregard

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A 74 y/o previously healthy Caucasian male comes to his physician's office complaining of abrupt onset fever, headache, myalgias, malaise, cough and throat pain. His two granddaughters missed several days of school because of similar symptoms. Examination demonstrates mild hyperemia of the throat without any exudate, and the patient is sent home on conservative management. Five days later, he is admitted to the hospital with progressive dyspnea, chest pain, and productive cough. Which of the following pathogens is most likely to be isolated from the patient's sputum?

a) S. aureus
b) S. pneumoniae

Pathoma [page 88, Table 9.2] says that "S. aureus is the most common cause of secondary pneumonia" while UW [QID 1666] says that "In order, the pathogens most often responsible for secondary bacterial pneumonia are S. pneumoniae, S. aureus, and H. flu"

Ideas?
I just got this UWorld question yesterday and the correct answer was S. aureus. This is consistent with Goljan RR Path and with what my professors told me.
 
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johndoe3344

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The correct answer was S. aureus only because S. pneumoniae wasn't a choice.

In the explanation it says S. pneumo is the MCC.
 

MrBeauregard

Soon-to-be PGY-1
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So then go with S. pneumoniae. Medscape and the CDC website are both consistent with UWorld's explanation of the order of the most common pathogens causing bacterial co-infection. Goljan and Pathoma are incorrect, I guess.