A 23-Year-Old Man Comes to the Physician with a 1-Week

A 23-year-old man comes to the physician with a 1-week history of sharp, substernal chest pain that is worse with inspiration and relieved with leaning forward. He has also had nausea and myalgias. He has end-stage kidney disease related to polycycstic kidney disease and receives intermittent hemodialysis through a tunneled catheter.  Temperature is 39 C (102.2 F) , blood pressure is 108/64 mm Hg, and pulse is 120/min.  The patient is ill-appearing. Cardiac examination shows a high-pitched rubbing sound between S1 and S2 that is best heard at the left sternal border. Echocardiography reveals a moderate-sized pericardial effusion.  Pericardiocentesis yields turbid fluid with a large number of neutrophils.  Microbiologic analysis of this patient's pericardial fluid is most likely to reveal which of the following pathogens?

A) Bacilli with acid-fast cell walls
B) Budding yeasts forming germ tubes
C) Gram-positive cocci growing in clusters
D) Lactose-fermenting gram-negative bacilli
E) Silver stain-positive motile spirochetes
F) Single-stranded RNA virus

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