01-30-2007, 03:01 PM
A 37-year-old woman comes to the physician because of a 1-day history of throbbing facial pain. She describes the pain as 7 out of 10 in intensity. Over the past 9 days, she has had nasal congestion, purulent nasal discharge, sore throat, and a nonproductive cough. She does not smoke. Her husband and children have had no recent illness. Her temperature is 38.5 C (101.3 F). Examination shows congested nasal mucosa and purulent discharge on the left. There is tenderness to palpation over the left cheek and no transillumination over the left maxillary sinus. The tympanic membranes are normal, and there is no erythema of the throat. Examination shows no cervical adenopathy. The lungs are clear to auscultation. Which of the following is the most likely causal organism?
A
) Haemophilus influenzae type b
B
) Moraxella catarrhalis
C
) Staphylococcus aureus
D
) Streptococcus pneumoniae
E
) Streptococcus pyogenes (group A)
A
) Haemophilus influenzae type b
B
) Moraxella catarrhalis
C
) Staphylococcus aureus
D
) Streptococcus pneumoniae
E
) Streptococcus pyogenes (group A)