A 29-year-old previously healthy female presented with a productive cough, fever to 102 oF, and severe headache. She had cervical adenopathy (swollen glands), although she had a nonerythematous throat with no exudate. Chest examination showed crackles bilaterally at the lung base with decreased breath sounds diffusely. This finding was confirmed by chest film that showed bilateral multifocal areas of patchy consolidation. Her neck was not stiff, but because of the severity of the headache, she was admitted to the neurologic service. A spinal fluid was obtained and was negative for bacteria, cryptococcus, and acid-fast smear. Blood cultures and sputum cultures did not produce a pathogen. The patient did not improve on ceftriaxone. On day 3 she was started on erythromycin. On day 4, cold agglutinins were done and were positive. The patient gradually improved although the headache, photophobia, and cough continued for some time QUESTIONS: 1. What is the agent of this disease? 2. Can you explain why the bacterial cultures were negative? 3. Why is erythromycin an effective therapy but ceftriaxone is not?

Microbiology for Surgical Technologists (MindTap Course List)
2nd Edition
ISBN:9781111306663
Author:Margaret Rodriguez, Paul Price
Publisher:Margaret Rodriguez, Paul Price
Chapter22: Emerging, Recurring, And Reappearing Diseases
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A 29-year-old previously healthy female presented with a productive cough, fever to 102 oF, and severe headache. She had cervical adenopathy (swollen glands), although she had a nonerythematous throat with no exudate. Chest examination showed crackles bilaterally at the lung base with decreased breath sounds diffusely. This finding was confirmed by chest film that showed bilateral multifocal areas of patchy consolidation. Her neck was not stiff, but because of the severity of the headache, she was admitted to the neurologic service. A spinal fluid was obtained and was negative for bacteria, cryptococcus, and acid-fast smear. Blood cultures and sputum cultures did not produce a pathogen. The patient did not improve on ceftriaxone. On day 3 she was started on erythromycin. On day 4, cold agglutinins were done and were positive. The patient gradually improved although the headache, photophobia, and cough continued for some time QUESTIONS: 1. What is the agent of this disease? 2. Can you explain why the bacterial cultures were negative? 3. Why is erythromycin an effective therapy but ceftriaxone is not?
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