A 36-year-old mother of two children presents with a 4-day history of swollen, painful hands. Her wrists and metacarpophalangeal joints are boggy and inflamed bilaterally. Her 5-year-old son had been sent home from school approximately 3 weeks previously with red cheeks and a blotchy rash on his torso. What is the most likely diagnosis?
A 16-year-old girl presents with a painlessly enlarged lymph node in her right axilla. Peripheral blood counts are within normal limits. The lymph node is biopsied, and numerous granulomas filled with neutrophils and necrotic debris are observed. Which of the following organisms could produce this disease?
A newborn in the neonatal intensive care unit becomes tachypneic and irritable. Blood cultures grow a gram-positive coccus in chains that is presumed to be a streptococcus. Which of the following characteristics would help to differentiate Streptococcus agalactiae from Streptococcus pneumoniae?
Zygomycosis, a destructive fungal infection of the sinuses, is likely to reach the brain by which of the following routes?
A child with sickle cell anemia is seen in a hematology clinic. Her mother states that she has been feeling very tired lately, and may have 'come down with a virus.' On physical examination, the girl is very pale, and a complete blood count shows severe anemia. A bone marrow aspirate contains no erythroid precursor cells. The girl was probably infected with which of the following viruses?
A 47-year-old male presents with declining renal function characterized by oliguria, elevated blood urea nitrogen and creatinine, and hematuria . He also complains of nasal congestion and epistaxis. Review of systems is notable for occasional cough and hemoptysis. Examination shows mucosal ulceration and nasal septal perforation, but no polyps. Which of the following serum markers would likely be present in this case?
An otherwise healthy 3-year-old child is brought to the pediatrician with umbilicated, flesh-colored papules on his trunk. This condition is related to infection with which of the following viruses?
A 23-year-old man develops explosive watery diarrhea with blood, fecal leukocytes, and mucus approximately 3 days after eating chicken that was improperly cooked. Comma-shaped organisms were found in the fecal smea r along with red blood cells and leukocytes. Which of the following pathogens is the most likely cause of these symptoms?
A 25-year-old man presents with a high fever and generalized malaise. His condition deteriorates so rapidly that his friends decide to take him to the emergency department 24 hours after the onset of symptoms. He has a history of intravenous drug abuse. A test for anti-HIV antibodies is negative. Physical examination reveals a systolic murmur, and echocardiography shows bulky vegetations attached to the tricuspid valve leaflets. Which of the following microorganisms will be most likely be isolated from this patient's blood cultures?
A 49-year-old Vietnamese man is diagnosed with tuberculosis. On physical examination, large flocculent masses are noted over the lateral lumbar back , and a similar mass is located in the ipsilateral groin. This pattern of involvement strongly suggests an abscess tracking along the