Presented by: Dr. Michael T. Kelly
MDS Metro



A 32 year old woman was seen in a family medicine clinic with a 24h history of severe pelvic pain described by the patient as "worse than having a baby." She also complained of right lower quadrant pain, low back pain, and constant lower abdominal cramping. Physical examination revealed a "toxic appearing" patient with fever and normal blood pressure. Upon pelvic examination, a purulent cervical discharge was noted. An intrauterine device that had been in place for one year was removed. The purulent cervical discharge was sent to the laboratory for gram stain and culture. The gram stain showed abundant PMNs and gram negative bacilli. Cultures yielded heavy growth of an oxidase positive, fermentative, gram negative bacillus.

1. What type of infection does this patient have?
   
   
2. Based on the characteristics described, what group of organisms is most likely involved in this infection?
   
   
3. What are the key biochemical reactions for identification of this isolate?

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