A 57-year-old male presents to the emergency department with a fever, productive cough, and complaining of chest pain. A STAT Gram stain reveals gram-positive oval-shaped cocci in pairs. You should suspect

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The gram-positive oval-shaped cocci in pairs seen on Gram stain is a characteristic feature of Streptococcus pneumoniae. This organism is known to cause pneumonia, which would be consistent with the patient's symptoms of fever, productive cough, and chest pain. Streptococcus pyogenes is also a gram-positive cocci, but it typically appears in chains rather than pairs and is more commonly associated with pharyngitis and skin infections rather than pneumonia. Streptococcus agalactiae and Enterococcus faecalis are also gram-positive cocci, but they are more commonly associated with urinary tract infections and bacteremia, respectively, and are less likely to cause pneumonia.

A 57-Year-Old Male Presents to the Emergency Department with a Fever