A 47-year-old woman is brought to the emergency department for the evaluation of fever, chest pain, and a cough productive of a moderate amount of greenish-yellow sputum for 2 days. She has hypertension, hypercholesterolemia, and type 2 diabetes mellitus. She smoked one pack of cigarettes daily for 20 years, but quit 5 years ago. Current medications include simvastatin, captopril, and metformin. Temperature is 39°C (102.2°F), pulse is 110/min, respirations are 33/min, and blood pressure is 143/88 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 94%. Chest x-ray shows a dense infiltrate occupying the entire right lower lobe. Which of the following most likely accounts for the color of this patient's sputum?

Question

A 47-year-old woman is brought to the emergency department for the evaluation of fever, chest pain, and a cough productive of a moderate amount of greenish-yellow sputum for 2 days. She has hypertension, hypercholesterolemia, and type 2 diabetes mellitus. She smoked one pack of cigarettes daily for 20 years, but quit 5 years ago. Current medications include simvastatin, captopril, and metformin. Temperature is 39°C (102.2°F), pulse is 110/min, respirations are 33/min, and blood pressure is 143/88 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 94%.   Chest x-ray shows a dense infiltrate occupying the entire right lower lobe.  Which of the following most likely accounts for the color of this patient's sputum?

Quizplus · Accepted Answer

Eductional Objective: The green discoloration of pus or sputum seen during common bacterial infections is due to the presence of myeloperoxidase, a blue-green heme-based enzyme that is released from neutrophil azurophilic granules and forms hypochlorous acid (bleach).

A 47-Year-Old Woman Is Brought to the Emergency Department for the Evaluation