A 78-Year-Old Man Is Brought to the Emergency Department Due

A 78-year-old man is brought to the emergency department due to fever, cough, and shortness of breath.  The patient recently moved into an assisted living facility after living with his family that owned several pets.  He has a 40-pack-year smoking history.  Temperature is 39.4 C (103 F) , blood pressure is 106/62 mm Hg, pulse is 112/min, and respirations are 28/min.  There is dullness to percussion and bronchial breath sounds over the left lung.  Chest x-ray reveals a left lower lobe consolidation.  Sputum microscopy shows gram-positive diplococci.  Which of the following would have been most helpful in preventing this patient's lung infection?

A) Avoidance of exposure to bird droppings
B) Immediate chemoprophylaxis after exposure
C) Immunization with inactivated microbial agent
D) Periodic culture and disinfection of water supply
E) Vaccination with bacterial polysaccharide

Correct Answer:

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