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PANCE Practice Question for April 2nd

An 8-year-old boy has left leg pain and a high fever, and has been refusing to walk since yesterday. On physical examination, his temperature is 39.8ordmC (103.6ordmF), blood pressure 122/68 mm Hg, pulse 102/min, and respirations 20/min. The left femur is tender to palpation 3 cm above the left knee and there is marked soft-tissue swelling. Radiograph of the left leg is normal. Bone scan shows increased uptake around the metaphysis of the left femur.

Which of the following is the most likely pathogen?

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