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The Gram Stain
- University of Miami School of Medicine; Miami Beach, FL 33139 Requests for Reprints: Arthur M. Fournier, MD, University of Miami School of Medicine, PO Box 016700 (R700), Miami, FL 33101.
The intern on my ward team presented her patient succinctly: “A 38-year-old man presents with a 1-week history of fever, pleuritic chest pain, and rust-tinged sputum. Chest x-ray shows a lobar infiltrate.”
“Sounds like pneumonia,” I offered. “What did you treat him with?”
“Timentin and gentamicin, one dose … He was in the hospital just a few weeks ago … We couldn't be sure what we were treating … . ”
“Fever, pleuritic pain, rust-tinged sputum, lobar infiltrate-sounds like strep pneumoniae to me. Penicillin is still a wonder drug against strep pneumoniae, and it's so inexpensive. Why not do a Gram stain and be sure of what you're treating?”
My resident leaped to his intern's defense.
“Dr. Fournier, they don't let us do Gram stains any more. It's against …
