A 68-year-old woman with newly diagnosed acute myeloid leukemia presented to the emergency department with a 102 F fever and a productive cough. The patient had recently returned from a family ski trip, where she said her husband had developed a cough and low fever, but had recovered. Expectorated sputum and blood were submitted to the microbiology laboratory for a respiratory pathogen polymerase chain reaction (PCR) panel and culturing. The respiratory panel was negative; however, gram-positive cocci in pairs and chains were observed in the aerobic and anaerobic Gram stain from blood culture. Subculturing revealed the growth was alpha-hemolytic on sheep blood agar and did not grow on MacConkey agar. Species identification was presumptive after a PCR panel and confirmed by MALDI-TOF.

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Author Information

Ashton Creasy-Marrazzo, Ph.D., Memorial Sloan Kettering Cancer Center

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