Respiratory tract microbiomeDownloads

A 12-year-old boy presents to the emergency room with difficulty breathing after several days of severe sore throat. Further history reveals that his family immigrated recently from Eastern Europe and he has never previously seen a doctor. Physical exam shows cervical lymphadenopathy with extensive neck edema as well as the finding shown in the image provided. You suspect a bacteria that causes the disease by producing an AB type exotoxin. Which of the following is the proper medium to culture the most likely cause of this infection?

A 63-year-old man comes to the physician for evaluation of fever and a nonproductive cough for the past 2 weeks. During this period, he has also had fatigue, myalgia, and difficulty breathing. Five weeks ago, he underwent an aortic prosthetic valve replacement due to high-grade aortic stenosis. The patient has a history of hypertension, asthma, and type 2 diabetes mellitus. A colonoscopy 2 years ago was normal. The patient has smoked one pack of cigarettes daily for the past 40 years. He has never used illicit drugs. Current medications include aspirin, warfarin, lisinopril, metformin, inhaled albuterol, and a multivitamin. The patient appears lethargic. Temperature is 38.6°C (101.5°F), pulse is 105/min, and blood pressure is 140/60 mm Hg. Rales are heard on auscultation of the lungs. A grade 2/6, diastolic blowing murmur is heard over the left sternal border and radiates to the right sternal border. A photograph of his right index finger is shown. Laboratory studies show a leukocyte count of 13,800/mm3 and an erythrocyte sedimentation rate of 48 mm/h. Which of the following is the most likely causal organism?