A 61-year-old man presents with four days of fever, a dry cough and increasing breathlessness. His wife reports he has been muddled since yesterday and has passed several loose bowel motions. The previous weekend he spent two days landscaping his garden, opening and spreading several bags of commercial potting mix. His temperature is 39.1°C, heart rate 104/min, respiratory rate 24/min and oxygen saturation 91% on room air. Chest x-ray shows consolidation in the right lower lobe; serum sodium is 126 mmol/L (135–145) and alanine aminotransferase 88 U/L (<40). Which one of the following is the most likely causative organism?
More from AMC
See allA 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…
A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…
A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…
A 26-year-old backpacker is snorkelling off Port Douglas in far north Queensland in December when she feels a mild sting on her forearm, leaving only faint redn…
A 34-year-old man in suburban Sydney felt a sharp pinprick on the back of his hand while moving pot plants stacked against the house. Over the next two hours he…