Respiratory medicine: post-influenza staphylococcal pneumonia: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: post-influenza staphylococcal pneumonia

Sample item

A 24-year-old man develops high fever, haemoptysis and hypotension 5 days after influenza. The chest radiograph shows multiple cavitating nodules and thin-walled air-filled cysts. Which organism is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Staphylococcus aureus

Staphylococcus aureus is a feared cause of necrotising pneumonia after influenza, producing cavities and pneumatoceles, and Panton-Valentine leukocidin strains are especially destructive. Treatment needs an antistaphylococcal agent, with MRSA cover where it is prevalent.

Option by option

  • A. Legionella pneumophila

    Legionella follows water exposure and gives diarrhoea, confusion and hyponatraemia.

  • B. Haemophilus influenzae

    Haemophilus influenzae usually gives patchy bronchopneumonia in people with chronic lung disease.

  • C. Staphylococcus aureus (correct)

    Correct. Cavitation with pneumatoceles after influenza points to Staphylococcus aureus.

  • D. Streptococcus pneumoniae

    Pneumococcus is common after influenza but usually causes lobar consolidation without pneumatoceles.

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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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Staphylococcus aureus. Staphylococcus aureus is a feared cause of necrotising pneumonia after influenza, producing cavities and pneumatoceles, and Panton-Valentine leukocidin strains are especially destructive.

Why is "Legionella pneumophila" not the answer?

Legionella follows water exposure and gives diarrhoea, confusion and hyponatraemia.

Why is "Haemophilus influenzae" not the answer?

Haemophilus influenzae usually gives patchy bronchopneumonia in people with chronic lung disease.

Why is "Streptococcus pneumoniae" not the answer?

Pneumococcus is common after influenza but usually causes lobar consolidation without pneumatoceles.

What concept does this question test?

It tests Respiratory medicine: post-influenza staphylococcal pneumonia in General Medicine. Treatment needs an antistaphylococcal agent, with MRSA cover where it is prevalent.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: post-influenza staphylococcal pneumonia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.