Infectious Diseases · NEET PG Preparation Medicine
A 45-year-old immigrant from Southeast Asia presents to the emergency department with altered mental status, fever, and a generalized petechial rash.…
Practice question from Infectious Diseases (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.
hard · MCQ · Q-F59CFA
A 45-year-old immigrant from Southeast Asia presents to the emergency department with altered mental status, fever, and a generalized petechial rash. He has a history of untreated chronic Hepatitis B. Physical examination reveals hepatosplenomegaly and icterus. Blood cultures grow gram-negative bacilli that are bipolar-staining and exhibit characteristic "safety-pin" appearance on Wayson staining. He reports handling raw fish and seafood recently. Which of the following is the most likely causative organism?
- A.Vibrio vulnificusCorrect answer
- B.Yersinia pestis
- C.Burkholderia pseudomallei
- D.Vibrio cholerae
Solution
Patients with chronic liver disease (such as cirrhosis or Hepatitis B) are at significantly increased risk of severe, rapidly progressive sepsis and bullous skin lesions or petechiae/purpura when infected with Vibrio vulnificus, typically acquired through raw seafood ingestion or seawater exposure to wounds. Vibrio species are gram-negative curved rods, though the safety-pin appearance is classic for Yersinia, Vibrio can present aggressively in cirrhotic patients with primary septicemia.
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