A patient undergoing chemotherapy develops a cough. Acid-fast stain of his sputum shows rods and slightly longer forms, with some branching; they vary in their acidfast reaction from one area of the slide to the next. The acid-fast stain was performed by n experienced medical technologist and, when redone, showed the same variation. The growth was done aerobically. What is the most likely agent?

Question

Quizplus · Accepted Answer

Either Nocardia or MAI is possible from the clinical scenario, but the most likely agent from the acid-fast stain description, the focus of the question, is Nocardia. Also, MAI would not grow in 2 days (so some mention of time would be made) and Actinomyces would only grow anaerobically, which would also be stated. Chlamydophila would not grow except in tissue culture.

A Patient Undergoing Chemotherapy Develops a Cough