A patient presented with fever and cough. A sputum sample stained by Gram's method revealed Gram-positive diplococci with a capsule. What is the likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. The presence of Gram-positive diplococci with a capsule is characteristic of S. pneumoniae. This bacterium is a common cause of pneumonia, especially in patients with fever and cough. It is also known for causing infections such as otitis media and sinusitis. Staphylococcus aureus (B) is a Gram-positive cocci but does not typically form diplococci or have a capsule. Neisseria meningitidis (C) is a Gram-negative diplococcus commonly associated with meningitis, not pneumonia. Klebsiella pneumoniae (D) is a Gram-negative rod, not a diplococcus, and is more commonly associated with pneumonia in immunocompromised patients.

Correct Answer: A

Rationale: The most likely causative agent in this case is Staphylococcus epidermidis. This conclusion can be drawn based on the characteristics provided: Gram-positive cocci in clusters, catalase-positive, and coagulase-negative. Staphylococcus epidermidis fits all these criteria. Explanation of other choices: - Staphylococcus aureus: Typically coagulase-positive, so it does not match the characteristics given. - Streptococcus pyogenes: Gram-positive cocci in chains, not clusters. Also, it is catalase-negative. - Enterococcus faecalis: Gram-positive cocci in pairs or chains, not clusters. Additionally, it is catalase-negative. Therefore, Staphylococcus epidermidis is the most likely causative agent based on the provided characteristics.

Correct Answer: A

Rationale: Rationale: 1. Gram-negative rods suggest Enterobacteriaceae family. 2. Lactose fermenters narrow down to E. coli. 3. Green colonies on MacConkey agar indicate acid production. 4. E. coli is a common cause of pneumonia. Therefore, the most likely causative agent is Escherichia coli. Other choices are incorrect as Klebsiella is non-lactose fermenter, Pseudomonas is oxidase-positive, and Proteus is non-lactose fermenter.

Correct Answer: B

Rationale: The correct answer is B: Helicobacter pylori. This bacterium is known to be the primary cause of peptic ulcers by colonizing the stomach lining and causing inflammation. It produces urease enzyme to neutralize stomach acid and has a flagellum for mobility. Escherichia coli (A) is mainly associated with foodborne illnesses. Streptococcus pyogenes (C) causes strep throat and skin infections. Mycobacterium tuberculosis (D) causes tuberculosis, a respiratory infection. Therefore, Helicobacter pylori is the correct choice for peptic ulcers based on its unique characteristics and pathogenicity.

Correct Answer: C

Rationale: The correct answer is C: Staphylococcus aureus. This bacterium is commonly associated with hospital-acquired infections due to its ability to cause a wide range of infections and its resistance to multiple antibiotics. Staphylococcus aureus can cause skin infections, pneumonia, bloodstream infections, and surgical site infections, making it a significant threat in healthcare settings. Escherichia coli (choice A) is more commonly associated with foodborne illnesses. Clostridium difficile (choice B) is known for causing antibiotic-associated diarrhea. Bacillus anthracis (choice D) is primarily associated with anthrax infections, which are not typically acquired in hospital settings.