Clinical Case Study

A 45-year-old woman is being treated in the hospital for pneumonia complicated by septicemia. She has required multiple antibiotics and was intubated and mechanically ventilated earlier in the course. On day 20 of hospitalization, she has abdominal distention. Bowel sounds are absent, and abdominal radiograph shows dilated loops of small bowel suggestive of ileus. She has a low volume of bloody stool.



Here are the 2 images of her small bowel:

  

                            

                  

Questions 

1. Based on these clinical findings, what is the likely causative agent?

2. Explain how you were able to identify the organism. 

3. Which of the following are appropriate specimen samples for anaerobe culturing:

1. blood, spinal fluid, abscess aspirate
2. deep tissue biopsy, sputum, blood
3. cerebrospinal fluid, tissue and debridement from decubitus ulcer, bile
4. tissue swabs, blood, urine