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G184

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Gram – Wound: 3+ (6-10/oif) neutrophils; 4+ (>50/oif) gram positive bacilli (Nocardia species) – Shipped February 11, 2019

HISTORY

A simulated wound sample collected from 58 year old leukemia patient with a subcutaneous abscess was sent to category A, C, and C1 laboratories.

Participants were expected to report the presence of neutrophils and gram positive bacilli.

 

MAIN EDUCATIONAL POINTS from G184

  1. Gram positive bacilli with a beading, branching morphology in the Gram stain is often a first clue for nocardiosis and may warrant the addition of selective media or extended incubation for recovery.
  2. A modified acid-fast and acid-fast stain can assist in the preliminary identification.

 

Full critique (PDF)

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