03-05-2011, 01:06 PM
The day after hunting and skinning
wild rabbits, a hunter develops an
inflamed papule on one finger. The
papule rapidly enlarges and then
bursts, releasing pus and forming a
clean ulcer cavity productive of thin,
colorless exudate. Several days later,
the patient develops severe illness
with atypical pneumonia and delirium.
It is at this point that the patient
seeks medical care. The regional lymph
nodes of the axilla of the affected
arm are enlarged. Reduced breath
sounds and occasional rales are heard.
Splenomegaly is noted. Blood studies
show a mild leukocytosis. Which of the
following is the most likely
diagnosis?
A. Actinomycosis
B. Brucellosis
C. Melioidosis
D. Plague
E. Tularemia
wild rabbits, a hunter develops an
inflamed papule on one finger. The
papule rapidly enlarges and then
bursts, releasing pus and forming a
clean ulcer cavity productive of thin,
colorless exudate. Several days later,
the patient develops severe illness
with atypical pneumonia and delirium.
It is at this point that the patient
seeks medical care. The regional lymph
nodes of the axilla of the affected
arm are enlarged. Reduced breath
sounds and occasional rales are heard.
Splenomegaly is noted. Blood studies
show a mild leukocytosis. Which of the
following is the most likely
diagnosis?
A. Actinomycosis
B. Brucellosis
C. Melioidosis
D. Plague
E. Tularemia