A 54-Year-Old Man Comes to the Emergency Department Due to Worsening

A 54-year-old man comes to the emergency department due to worsening fever, cough, and shortness of breath.  The patient initially presented a week ago with a fever, headache, myalgia, nasal discharge, and a sore throat.  He tested positive for influenza A and was discharged home with symptomatic treatment.  The patient's symptoms gradually improved, but over the past 2 days he has had high fevers, cough productive of yellowish sputum, sharp right-sided chest pain, and shortness of breath.  The patient has no other medical problems and does not use tobacco, alcohol, or illicit drugs.  Temperature is 38.9 C (102 F) , blood pressure is 118/66 mm Hg, and pulse is 110/min.  Physical examination reveals right-sided lung crackles.  Chest x-ray reveals infiltrates in the right lung.  Which of the following pathogens is most likely to be isolated from this patient's sputum?

A) Cytomegalovirus
B) Klebsiella pneumoniae
C) Listeria monocytogenes
D) Nontuberculous mycobacteria
E) Staphylococcus aureus

Correct Answer:

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