A physician inquires about repeated sputum specimens that ar…
A physician inquires about repeated sputum specimens that are reported to contain only normal oropharyngeal flora. The patient is a 67 yr old man who smokes and has a persistent cough, malaise, and a fever of 102°C. Treatment with routine antimicrobials has not been effective. The most recent direct Gram’s stain of sputum shows 3+ PMNs and rare epithelial cells. A likely etiologic agent is (M35-1, 2, 3; Level 3):