The patient is a 30-year-old male who presents to the Emergency Department with a recent travel history to Africa where he spent 6 months as a Peace Corps Volunteer in Uganda. His chief complaint is fevers, headache, myalgias, and shaking chills. T 39.6°C (103.3°F). The patient was admitted for observation and further work-up. The patient had documented episodes of fever and chills approximately 3 times a day. Based on this information, which of the following laboratory tests would confirm your diagnostic suspicion?

This type of atypical mycobacterium is found in fresh water or salt water; infection occurs following exposure of a skin or soft tissue injury to the organism, often in a fish tank or other marine animal setting, and typically results in granuloma formation.

Which of the following statements pertaining to rabies is TRUE?

A woman presents to your office after a 6-month sabbatical during which she worked in caves in the eastern part of South America. The patient reports fever, chills, productive cough, and joint stiffness that started 1 month before her return. Physical exam reveals 3 ulcerated lesions on her inner cheek. Which of the following is the most appropriate treatment for this patient?

Primary infection with this organism in immunocompetent persons typically follows ingestion of raw or undercooked meat. Although most acute infections are asymptomatic, some patients present with a mild febrile illness resembling infectious mononucleosis. What is the most likely causative pathogen for this illness?

A 22-year-old man presents to the emergency department with a burning cut on his left arm. The patient states that he noticed a few cuts along his arm which have become more swollen and are associated with bumps. He now feels fatigued and has a fever. The patient is otherwise healthy and is not currently taking any medications. The patient lives alone, is a student, and owns a new cat. His temperature is 101°F (38.3°C), blood pressure is 120/88 mmHg, pulse is 97/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam is notable for the finding in the image (see below). There is notable tender lymphadenopathy in the ipsilateral antecubital fossa and axilla. Which of the following is the most likely infectious etiology of this patient’s symptoms? 

A 3-year-old boy is admitted to the Emergency Department in acute respiratory distress. The patient has T: 40°C (104°F), RR: 70/min, and HR:130/min. Auscultation of the lungs is unremarkable. An examination of the throat reveals an exudate in the posterior pharynx that is yellowish and membranous. Bleeding occurs when it is scraped and removed. The parents of the child reveal that the child has received no prior immunizations. A throat culture was ordered and worked up specifically for an organism that selectively grows on cystine tellurite agar. What organism is causing this child’s disease?

A 68-year-old female presents to the Emergency Department with several days of frequent, non-bloody, watery stools. She recently completed a course of clindamycin two weeks ago for a tooth infection. Her medical history is notable for hypertension and hyperlipidemia for which she takes amlodipine and atorvastatin. She has no sick contacts and has not traveled recently. Vital signs: T 98.6°F, BP 118/82 mmHg, HR 98/min, RR 14/min, and oxygen saturation is 98% on room air. On exam, her abdomen is soft, non-distended, and diffusely tender to palpation in the lower quadrants bilaterally. Which of the following is the initial diagnostic test of choice for this patient?

A 54-year-old male with HIV presents to the Emergency Department with worsening dry cough, now with increasing shortness of breath. He is currently on antiretroviral therapy. On exam, his temperature is 98.4°F (36.9°C), blood pressure is 124/83 mmHg, pulse is 110/min, respirations are 24/min, and oxygen saturation is 91% on room air. Diffuse crackles are present upon auscultation of bilateral lungs. His most recent CD4 cell count is 140/mm3 and an arterial blood gas reveals a PaO2 of 60 mmHg. CXR is noted to have extensive interstitial infiltrates. Which of the following is the most appropriate treatment for the patient at this time?

Which of the following statements about the diagnosis of human immunodeficiency virus (HIV) is TRUE?