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.
Did you guess the diagnosis?Watch the reveal video to learn the diagnosis and treatment.
Ashton Creasy-Marrazzo, Ph.D., Memorial Sloan Kettering Cancer Center
Stay up to date on all ASM Clinical Public Health Microbiology (CPHM) activities when you sign up for our monthly CPHM Newsletter. Be the first to know about free educational webinars, continuing education credit opportunities, advocacy, updated guidelines and more.