Streptococcus pneumoniae

A 3-year-old child from rural Maharashtra presents with fever (39.5°C), purulent nasal discharge, and cough for 5 days. On examination, there is mild left ear tenderness and a dull tympanum. A Gram stain of middle ear fluid obtained by tympanocentesis shows Gram-positive diplococci. Culture is pending. What is the most appropriate immediate next step in management?

Streptococcus pneumoniae is catalase-negative, but which enzymatic virulence factor does it produce that directly causes tissue damage and hemolysis by forming pores in host cell membranes?

A 3-year-old child from rural Maharashtra presents with acute bacterial meningitis. CSF shows elevated protein (120 mg/dL), low glucose (20 mg/dL), and Gram-positive diplococci. Blood culture grows Streptococcus pneumoniae sensitive to penicillin (MIC 0.06 µg/mL). What is the drug of choice for meningitis in this case?

A 65-year-old man with COPD and asplenia presents with community-acquired pneumonia. Sputum culture yields *Streptococcus pneumoniae* with penicillin MIC 2 µg/mL (non-meningitis). What is the drug of choice?

A 62-year-old man from rural Maharashtra presents with fever, productive cough, and pleuritic chest pain for 4 days. Chest X-ray shows right lower lobe consolidation. Blood culture grows gram-positive diplococci catalase-negative. Regarding the laboratory identification and antibiotic susceptibility of this organism, all of the following are correct EXCEPT: