Reference no: EM133394023

Question: The patient was a 15 year-old male with a history of sickle cell disease. On the morning of hospital admission he presented with a 4 day history of a cough productive of sputum and 2 days of spiking fevers. On admission, his temperature was 41.1 °C, his respiratory rate was 40/min, pulse was 120 beats/min, and his blood pressure was 80/40 mm Hg. He was alert and in mild respiratory distress. Chest examination was notable for decreased breath sounds by auscultation and dullness to percussion. Initial laboratory studies included a hematocrit of 13.6% and a white blood cell (leukocyte, WBC) count of 52,400 mm3 with 86% neutrophils. A gram stain was performed on the sputum (see the photo below). A chest radiograph demonstrated a right lower lobe infiltrate. A blood culture was subsequently positive for gram-positive cocci in pairs (diplococci). On the blood agar plate the organism was alpha-hemolytic and had a mucoid consistency. The organisms isolated from the sputum and blood cultures were catalase negative, lancet-shaped, gram positive cocci in pairs and short chains. These organisms appeared to be encapsulated.

? Was it appropriate to perform a Gram stain on the sputum specimen?