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Pediatrics · Paediatric infections: staphylococcal pneumonia
Sample itemA 10-month-old with skin pustules a week ago now has high fever, fast breathing and grunting. The chest radiograph shows thin-walled air-filled cysts and a right pyopneumothorax. Which organism is the most likely cause?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Staphylococcus aureus
Staphylococcal pneumonia in infants often follows a skin infection and causes rapidly progressive pneumonia with pneumatoceles, empyema and pyopneumothorax. Treatment needs anti-staphylococcal antibiotics, and an intercostal drain for the pyopneumothorax. Pneumococcal pneumonia usually gives a lobar consolidation.
Option by option
A. Mycoplasma pneumoniae
Mycoplasma causes mild interstitial disease in older children.
B. Haemophilus influenzae type b
Hib pneumonia is now uncommon after vaccination and rarely forms pneumatoceles.
C. Streptococcus pneumoniae
Pneumococcus typically causes lobar consolidation and parapneumonic effusion without pneumatoceles.
D. Staphylococcus aureus (correct)
Correct. Pneumatoceles with pyopneumothorax after skin sepsis point to S. aureus.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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