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Chapter 15: Enteric Gram-Negative Rods (Enterobacteriaceae)

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A 20-year-old college student goes to the student health center because of dysuria, frequency, and urgency on urination for 24 hours. She has recently become sexually active. On urinalysis, many polymorphonuclear cells are seen. The most likely organism responsible for these symptoms and signs is

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(A) Staphylococcus aureus

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(B) Streptococcus agalactiae

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(C) Gardnerella vaginalis

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(D) Lactobacillus species

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(E) Escherichia coli

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A 27-year-old woman is admitted to the hospital because of fever, with increasing anorexia, headache, weakness, and altered mental status of 2 days’ duration. She works for an airline as a cabin attendant, flying between the Indian subcontinent and other places in Southeast Asia and the West Coast of the United States. Ten days before admission, she had a diarrheal illness that lasted for about 36 hours. She has been constipated for the past 3 days. Her temperature is 39°C, heart rate is 68 beats/min, blood pressure is 120/80 mm Hg, and respirations are 18 breaths/min. She knows who she is and where she is but does not know the date. She is picking at the bedclothes. Rose spots are seen on her trunk. The remainder of the physical examination is normal. Blood cultures are done, and an intravenous line is placed. The most likely cause of her illness is

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(A) Enterotoxigenic Escherichia coli (ETEC)

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(B) Shigella sonnei

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(C) Salmonella enterica subspecies enterica serotype Typhimurium (Salmonella Typhimurium)

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(D) Salmonella enterica subspecies enterica serotype Typhi (Salmonella Typhi)

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(E) Enteroinvasive Escherichia coli (EIEC)

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A 27-year-old woman is admitted to the hospital because of fever, with increasing anorexia, headache, weakness, and altered mental status of 2 days’ duration. She works for an airline as a cabin attendant, flying between the Indian subcontinent and other places in Southeast Asia and the West Coast of the United States. Ten days before admission, she had a diarrheal illness that lasted for about 36 hours. She has been constipated for the past 3 days. Her temperature is 39°C, heart rate is 68 beats/min, blood pressure is 120/80 mm Hg, and respirations are 18 breaths/min. She knows who she is and where she is but does not know the date. She is picking at the bedclothes. Rose spots are seen on her trunk. The remainder of the physical examination is normal. Blood cultures are done, and an intravenous line is placed.

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Blood cultures from the patient grow a non–lactose-fermenting gram-negative ...

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