A 65-year-old man comes to his physician because of progressively worsening shortness of breath for the past 2 months. He does not experience shortness of breath at rest. He also occasionally has a dry cough. He has not had fever, chills, or night sweats. The patient has smoked a pack of cigarettes daily for 40 years. His temperature is 37°C (98.6°F), pulse is 86/min, respirations are 22/min, and blood pressure is 133/85 mm Hg. Lung auscultation reveals a prolonged expiratory phase and end-expiratory wheezing. Sputum cultures in specialized media grow round-to-oval, budding yeast, which form germ tubes when incubated at 37 C in serum. Which of the following best explains the presence of the organism in this patient's sputum sample?

Question

A 65-year-old man comes to his physician because of progressively worsening shortness of breath for the past 2 months. He does not experience shortness of breath at rest. He also occasionally has a dry cough. He has not had fever, chills, or night sweats. The patient has smoked a pack of cigarettes daily for 40 years. His temperature is 37°C (98.6°F), pulse is 86/min, respirations are 22/min, and blood pressure is 133/85 mm Hg. Lung auscultation reveals a prolonged expiratory phase and end-expiratory wheezing. Sputum cultures in specialized media grow round-to-oval, budding yeast, which form germ tubes when incubated at 37 C in serum.  Which of the following best explains the presence of the organism in this patient's sputum sample?

Quizplus · Accepted Answer

Eductional Objective: Expectorated sputum cultures are often contaminated by normal oral flora.  The growth of Candida albicans, a normal commensal of the gastrointestinal tract and skin, almost always indicates oral contamination rather than true pulmonary infection.

A 65-Year-Old Man Comes to His Physician Because of Progressively