A Case Study: Bronchitis

A woman in her 70s comes in with acutely exacerbating bronchiectasis. She does not smoke but has chronic sinusitis and claims to have been exposed to secondhand smoke. The patient had just visited Savannah, Georgia when she got sick and started coughing. She was given a doxycycline prescription before being discharged. Her cough worsened, so she went back to the pulmonary clinic for a follow-up appointment. The mixed respiratory flora was minimal to nonexistent, and the Gram stain and smear revealed 4+ neutrophils and 4+ gram-negative coccobacilli. The culture produced no growth on the MacConkey plate the following day, 1+ respiratory flora on the blood plate, and 4+ transparent colonies on the chocolate plate.