A wound culture revealed Gram-negative rods that are lactose non-fermenters. The bacteria were isolated from a patient with a deep tissue infection. What is the most likely microorganism?

Correct Answer: A

Rationale: The correct answer is A: Pseudomonas aeruginosa. P. aeruginosa is a Gram-negative rod that is a lactose non-fermenter commonly associated with deep tissue infections. It is an opportunistic pathogen known for its ability to cause infections in immunocompromised individuals. P. aeruginosa is often resistant to multiple antibiotics and can form biofilms, making it difficult to treat. Summary of why other choices are incorrect: B: Escherichia coli is a Gram-negative rod that ferments lactose and is commonly found in the gastrointestinal tract. It is not typically associated with deep tissue infections. C: Salmonella typhi is a Gram-negative rod that causes typhoid fever, primarily affecting the gastrointestinal system, not deep tissue infections. D: Shigella dysenteriae is a Gram-negative rod that causes bacillary dysentery, which primarily affects the gastrointestinal tract and does not typically cause deep tissue infections.

Correct Answer: A

Rationale: The correct answer is A: Entamoeba histolytica. This is because the presence of cysts with four nuclei is characteristic of Entamoeba histolytica, a protozoan parasite that causes amoebic dysentery. Entamoeba histolytica cysts contain four nuclei, distinguishing them from other pathogens. Giardia lamblia and Trichomonas vaginalis are not associated with cysts containing four nuclei. Balantidium coli is a ciliated protozoan that does not typically form cysts with multiple nuclei. In summary, the unique feature of four nuclei in the cysts points towards Entamoeba histolytica as the most likely causative agent of the diarrhea in this patient.

Correct Answer: C

Rationale: Rationale: 1. Vibrio cholerae produces cholera toxin causing severe diarrhea. 2. Clostridium tetani causes tetanus, not diarrhea. 3. Clostridium botulinum causes botulism, not diarrhea. 4. Shigella dysenteriae causes dysentery, not typical diarrhea. Summary: A: Incorrect, causes tetanus. B: Incorrect, causes botulism. C: Correct, produces cholera toxin causing severe diarrhea. D: Incorrect, causes dysentery.

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: B

Rationale: The correct answer is B: Enable bacterial adherence to surfaces. Bacterial capsules are a protective layer outside the cell wall that helps bacteria adhere to surfaces and evade host immune responses. This allows bacteria to colonize and infect host tissues. A: Enhancing bacterial motility is typically associated with flagella, not capsules. C: Bacterial DNA replication is not directly affected by capsules. D: Bacterial capsules do play a role in protecting bacteria from desiccation by providing a barrier against drying out. However, the primary function is enabling adherence to surfaces.