Wiggle on by
A 5-year-old child presents with perianal itching and disturbed sleep. Otherwise, development and physical exam are normal. Upon questioning, other members of the household admit to similar symptoms.
What is Enterobius?
*Bonus: pathogenesis*
A 70-year-old woman from rural New Jersey presents with fever, thrombocytopenia and anemia. She has felt tired and anorexic for several weeks. She reports “a lot of ticks this year” and tells you that years ago she lost her spleen following a car accident
What is Babesia?
*Bonus: pathogenesis*
What is Borrelia burgdoferi?
*Bonus #1: microbiology*
*Bonus #2: vector*
*Bonus #3: reservoir*
An exchange student who has spent a year living in a rural part of somewhere warm or temperate, eating local food, is asymptomatic, but passes a 25 cm pencil-thick worm.
What is Ascaris?
*Bonus: pathogenesis*
A 19-year-old returns from a study abroad in France, where he learned to appreciate lamb cooked rare. He complains of fever, fatigue and night sweats. On examination he has cervical lymphadenopathy. A serological test is reported as positive.
What is Toxoplasmosis?
*Bonus: pathogenesis*
A 25-year-old woman presents to clinic with painful axillary adenopathy and flu-like symptoms. Her symptoms began after playing with a recently rescued cat.
What is Bartonella henselae?
*Bonus: microbiology*
A 40-year-old who grew up in a rural tropical area is being evaluated for a kidney transplant. He reports sporadic episodes of diarrhea and complains of mild abdominal discomfort. He has lived in this country for 15 years. A stool specimen reveals microscopic larval worms.
What is Strongyloidiasis?
*Bonus: pathogenesis*
A traveler returning from Sub-Saharan Africa presents with irregular spiking fevers. He has been visiting friends and family. He dispensed with prophylactic measures because he “had grown up there”. Examination of a stained film of peripheral blood shows intracellular forms.
What is Plasmodium?
*Bonus: pathogenesis*
A 30-year-old man presents with headache, fever, and a rash. He reports that the rash began on his palms and soles and has since spread to his trunk.
What is Rickettsia rickettsi?
*Bonus #1: microbiology*
*Bonus #2: vector*
A 60-year-old resident of a Caribbean island presents with ascites and esophageal varices. He has normal albumin, blood clotting factors and slightly elevated liver enzymes. A stool O&P examination reveals diagnostic eggs.
What is Schistosomiasis?
*Bonus: pathogenesis*
A 26-year-old woman, 30 weeks pregnant, is evaluated because ultrasound revealed intrauterine growth retardation. Imaging reveals small intracerebral calcifications in the fetus. A panel of serological tests is sent and
returns positive.
What is congenital Toxoplasmosis?
A 42 y/o rabbit farmer presents to clinic with a well-demarcated painful ulcer with a black base, regional adenopathy, and local inflammation.
What is Francisella tularensis?
*Bonus #1: microbiology*
*Bonus #2: vector*
*Bonus #3: ddx and how to differentiate*
A 3-year-old child, who spends a lot of time playing in his family’s sandbox, presents with fever, elevated liver enzymes, and a slightly enlarged liver by palpation. A peripheral blood count reveals eosinophilia.
What is Visceral larva migrans?
*Bonus: pathogenesis*
A 30-year-old returns from visiting somewhere with substantial fecal veneer, and complains of frequent small painful bowel movements, which consist of bloody mucus. The patient reports having frequently eaten “street food”
What is Entamoeba histolytica?
*Bonus: pathogenesis*
A 65 y/o vet presents to urgent care with flu-like symptoms for approximately 2 weeks, which began after he went to a farm to deliver a baby sheep.
What is Coxiella burnetii?
*Bonus #1: microbiology*