Arthur M. Fournier, MD
Fournier AM. The Gram Stain. Ann Intern Med. 1998;128:776. doi: 10.7326/0003-4819-128-9-199805010-00015
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Published: Ann Intern Med. 1998;128(9):776.
The intern on my ward team presented her patient succinctly: “A 38-year-old man presents with a 1-week history of fever, pleuritic chest pain, and rust-tinged sputum. Chest x-ray shows a lobar infiltrate.”
“Sounds like pneumonia,” I offered. “What did you treat him with?”
“Timentin and gentamicin, one dose … He was in the hospital just a few weeks ago … We couldn't be sure what we were treating … . ”
“Fever, pleuritic pain, rust-tinged sputum, lobar infiltrate-sounds like strep pneumoniae to me. Penicillin is still a wonder drug against strep pneumoniae, and it's so inexpensive. Why not do a Gram stain and be sure of what you're treating?”
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