03-22-2008, 02:12 PM
45. 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
A. Actinomycosis
B. Brucellosis
C. Melioidosis
D. Plague
E. Tularemia