A 37-year-old man was admitted to a local hospital complaining of a severe headache of several days, moderate fever, chest pain, and a productive cough. Swollen lymph nodes and a tender, enlarged liver were also noted. He is a professional furrier and trapper and had recently returned from an excursion on which he had trapped and skinned approximately 30 rabbits.

Routine sputum and blood cultures were collected and inoculated aerobically and anaerobically onto routine media (blood agar plate, MacConkey agar, and CA, and MAC). Although gram stains of both the blood and sputum seemed to demonstrate the presence of very faintly staining gram-negative cocco bacilli, no growth was obtained on any of the cultures after 72 hours.

After 6 days, the chocolate agar plates from the blood culture began to grow tiny transparent colonies of the organism. These colonies were oxidase negative and weakly catalase positive. Unable to conclusively identify the organism using any of their routine methods, the laboratory sent the isolate to a reference laboratory.

While awaiting the final identification results from the reference laboratory, the patients pneumonia condition worsened, complicated by liver failure, and he died 3 weeks following admission.

Questions:

- Given the patients history and symptoms, what disease and organism do you suspect has infected the patient?

- Assuming the laboratory was aware of the patients specific history; describe the special precautions that should have been taken when working on specimens from this patient.