A 41-year-old man visits the emergency room after experiencing a low-grade fever for three weeks, a cough that is producing mucus, and a 4.5 kg (10 lb) weight loss. The patient consumes 10 to 12 beers daily. He seems cachectic upon physical inspection. There are noticeable clubbed fingers and poor dental health. Sputum that has a bad odor is expectorated and sent for Gram staining and culture. The picture below shows a chest CT scan: Empiric antimicrobial therapy should include coverage against which of the following pathogens?

Question

A 41-year-old man visits the emergency room after experiencing a low-grade fever for three weeks, a cough that is producing mucus, and a 4.5 kg (10 lb) weight loss. The patient consumes 10 to 12 beers daily. He seems cachectic upon physical inspection. There are noticeable clubbed fingers and poor dental health. Sputum that has a bad odor is expectorated and sent for Gram staining and culture. The picture below shows a chest CT scan:  Empiric antimicrobial therapy should include coverage against which of the following pathogens?

Quizplus · Accepted Answer

Eductional Objective: Patients with alcohol use disorder are at increased risk for lung abscess due to the aspiration of oral flora during periods of unconsciousness.  Although many cases are polymicrobial, the main pathogens are strict and facultative anaerobic oral flora (eg, Bacteroides, Prevotella, Fusobacterium, Peptostreptococcus).  Manifestations include subacute fever, cough, and foul-smelling sputum.

A 41-Year-Old Man Visits the Emergency Room After Experiencing a Low-Grade