Considering the details of this case, what is the patient likely suffering from?
ID: 189904 • Letter: C
Question
Considering the details of this case, what is the patient likely suffering from?
A brand new type of bacterium, made by combining Gram-positive and Gram-negative bacteria
Lung cancer
Mycoplasma pneumoniae
A multi drug resistant Streptococcus pneumoniae
A 47 year old female patient presents herself to you with symptoms of pneumonia. All indications are that the patient is suffering from an infection of Streptococcus pneumoniae, a Gram-positive bacterium. Since the patient is not allergic to penicillin, you prescribe a dose of amoxicillin, a semi-synthetic penicillin. This drug works by blocking the peptide cross-links, between the muramic acid subunits, of peptidoglycan chains. This leads to a destabilization of the bacterial cell, leading to its rupture.
However, after the patient finished her course of amoxicillin, no improvement in symptoms were reported. Perplexed, you decide to culture and examine the bacteria infecting her lungs. The test you order is a Gram stain test, which comes back as Gram-negative. You feel like a failure as a health care provider due to your misdiagnosis of this bacterium.
The same day, you put the patient on an aminoglycoside class antibiotic. This antibiotic is Gram-negative specific and works by shutting down ribosomes. You are dismayed and confused when this treatment also fails.
To get a full read on the disease, you have a barcoding DNA test done on the causative bacterium. The test comes back and it clearly shows that the bacterium is within the group of Gram-positive bacteria. With the results of this test, you come up with the theory that the patient is infected with a strain of Drug Resistant Streptococcus pneumoniae (DRSP), resistant to amoxicillin. You decide to treat the DRSP by administering intravenous vancomycin, which is indicated for the treatment of serious, life-threatening infections by Gram-positive bacteria. This treatment also fails.
In the end, you figure out that you were wrong about everything, and that there was a simple solution to the treatment of the patient.
A.
A brand new type of bacterium, made by combining Gram-positive and Gram-negative bacteria
B.Lung cancer
C.Mycoplasma pneumoniae
D.A multi drug resistant Streptococcus pneumoniae
Explanation / Answer
In this case it is observed that both the treatment for the gram positive and gram negative bacteria fails. First the patient was treated with penicillin considering it to be an infection caused by Streptococcus pneumonia but it failed to curb the infection. Later, the patient was given amoxicillin suspecting it to be gram negative bacteria but that also failed. After completing the barcoding DNA test, it was found that the causative agent is gram positive bacteria which is drug resistant Streptococcus pneumonia and also is resistant to amoxicillin. On providing vancomycin, that treatment also fails.
Considering everything, the patient is most likely to be suffering from Mycoplasma pneumonia which shows symptoms like that of Pneumonia. It is caused by over 200+ species of the bacteria and it does not actually develop in Pneumonia but may cause similar symptoms.