A 14-year old boy presented with high grade fever and progressive dyspnea for 3 days. He had history of ankle pain during stepping downstairs without any wound or trauma 2 weeks ago. He refused history of contact TB. PE: T 39.5 °C, RR 50 /min, BP 100/60 mmHg, PR 130 /min, SpO2 92% while on O2 mask with bag 10 LPM, he was unable to talk in sentence, good consciousness, fine crepitation both lungs, mild left ankle swelling without wound.
1.What is the most likely pathogen and How does it spread to the lungs?
2.What is the proper antimicrobial ?
Ans1: Staphylococcus aureus, Hematogenous spreading
Ans2: Cloxacillin IV + Clindamycin IV