A patient with a productive cough and fever had a sputum smear revealing Gram-positive cocci in pairs with a capsule. What is the most likely causative agent?

Correct Answer: A

Rationale: The correct answer is A: Streptococcus pneumoniae. This bacterium is the most likely causative agent based on the description of Gram-positive cocci in pairs with a capsule. S. pneumoniae is known for its characteristic morphology and the presence of a capsule, which helps in evading the immune system. It commonly causes pneumonia, especially in patients with a productive cough and fever. Incorrect choices: B: Klebsiella pneumoniae typically presents with a mucoid capsule and is associated with pneumonia in immunocompromised individuals. C: Neisseria meningitidis is a Gram-negative diplococcus and is more commonly associated with meningitis and septicemia. D: Staphylococcus aureus is a Gram-positive cocci, but it does not typically present in pairs with a capsule and is more commonly associated with skin and soft tissue infections.

Correct Answer: A

Rationale: The correct answer is A: Clostridium botulinum. Clostridium botulinum produces the botulinum toxin, which causes botulism. This bacteria thrives in anaerobic environments and can contaminate improperly canned foods. Clostridium tetani causes tetanus, not botulism. Staphylococcus aureus produces enterotoxins causing food poisoning, not botulism. Escherichia coli can cause food poisoning through various toxins, but not botulism. Therefore, the correct choice is Clostridium botulinum as it specifically produces the botulinum toxin responsible for botulism.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Gram-positive rods with terminal spores suggest Clostridium genus. 2. Terminal spores are characteristic of Clostridium perfringens. 3. C. perfringens is known to cause wound infections. 4. Therefore, the most likely causative agent is Clostridium perfringens. Summary: A: Clostridium perfringens is correct due to its characteristic features and association with wound infections. B: Bacillus anthracis does not typically form terminal spores. C: Clostridium tetani causes tetanus, not wound infections. D: Bacillus cereus does not produce terminal spores like Clostridium perfringens.

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. This is because Pseudomonas is a Gram-negative rod, oxidase-positive, and non-lactose fermenter. These characteristics are typical of Pseudomonas species. B: Escherichia coli is a Gram-negative rod but is lactose fermenter and usually oxidase-negative. C: Klebsiella pneumoniae is a Gram-negative rod, non-lactose fermenter, but is usually oxidase-negative. D: Shigella dysenteriae is a Gram-negative rod, non-lactose fermenter, but is usually oxidase-negative and is more associated with causing shigellosis rather than deep tissue infections.

Correct Answer: B

Rationale: The correct answer is B: Vibrio cholerae. Cholera is caused by this specific bacterium due to its production of cholera toxin, leading to severe watery diarrhea. Shigella dysenteriae causes dysentery, Salmonella enterica causes salmonellosis, and Clostridium perfringens causes food poisoning, none of which present with the characteristic symptoms of cholera.