اتمنى مشاركتكم ومساعدتكم في الحل
the following table is the report relating to a 57-years old male smoker with fever, confusion, diarrhoea and non-productive cough.
__________________________________________________ ________________
bronchoalveolar lavage fluid microscopy :
leucocytes + + +
epithalial cell +
monocyte +
grame stain mixed bacteria
Acid -fast stain no acib fast bacilli seen

myobacterial culture result will be issued on a separate report
cultur results
mixed bacterial growth including- moraxella catarrhalis , pseudomonas aeroginosa , and viridans group streptococci

antibiotic susceptibilities of
M.catarrhalis
amoxicillin R
augmentin S
doxycline S
co-trimoxazole R
gentamicin S
ciprofloxacin S
timentin S
P. aeroginosa
co-trimoxazole S
gentamicin S
ciprofloxacin S
timentin S
__________________________________________________ ______________________

1- given the clinical features in this case, what possible bacterial cause of this infection has not been mentioned on this report?
2- dose a negative report rule out the possibility of the species mentioned in your answer to Q1 ?
3- what is the explanation for the presence of each of the bacteria mentioned in this report ?
4- what other microbiological investigation might help you to establish an etiological diagnosis in this case ?