This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Microbiology
A patient with history of discharge from right ear for past 1 year presented with severe ear ache. The discharge was cultured and the organism was found to be gram positive cocci. The least likely cause is? 
Select and explain. 
A. Pseudomonas, B. Streptococcus pneumoniae, C. Staphylococcus, D. Haemophilus influenza
D: Haemophilus influenza
Answer: D: Haemophilus influenza 
Explanation: Ans. (d) Hemophilus influenza Ref See below H. influenzae is a gram (-)ve coccobacilli Otitis media Etiologic bacteria Acute otitis media Pneumococci > H. influenzae > Moraxella > Streptococcus pyogenes Chronic otitis media Staph aureus > Pseudomonas