<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 71-year-old man comes to the emergency department because of pain and swelling in his left leg that started after he cut his foot while swimming in the ocean. He has a history of alcoholic cirrhosis. His temperature is 38.3C 101.0F. Examination of the left foot shows a small, purulent wound with surrounding swelling and dusky redness extending to the mid-calf. There are numerous hemorrhagic blisters and the entire lower leg is exquisitely tender to light palpation. There is no crepitus. Blood cultures grow gram-negative bacilli that ferment lactose. Which of the following is the most likely causal organism?? A: Shigella flexneri, B: Pseudomonas aeruginosa, C: Clostridium perfringens, D: Streptococcus pyogenes, E: Vibrio vulnificus,  <response>: This is a question about identifying the most likely causal organism in a patient with signs and symptoms of cellulitis and underlying alcoholic cirrhosis. The key details in the stem are: - 71-year-old man with alcoholic cirrhosis - Cut foot while swimming in the ocean, now has pain, swelling, purulent wound, dusky redness, hemorrhagic blisters in left lower leg- Fever- Gram-negative bacilli grew in blood cultures that ferment lactoseThe organism causes a wound infection after ocean exposure and systemic infection in an immunocompromised host. Vibrio vulnificus is a gram-negative bacterium found in warm ocean water that can cause severe skin and soft tissue infections, especially in people with liver disease. It ferments lactose. This makes it the most likely organism.Shigella, Pseudomonas, and Streptococcus pyogenes are less likely as they are not typically acquired from ocean water exposure. Clostridium perfringens can cause tissue necrosis but the lactose-fermenting gram-negative bacilli point more specifically to Vibrio vulnificus.E: Vibrio vulnificus 