doc_clotaire
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Four days after returning from a trekking trip in Louisiana, a 23-year-old, Caucasian, male college student presents with severe frontal headache, ocular pain, drowsiness, abdominal and back pain, sore throat, cough, as well as myalgia. He feels nauseated and he has lost his appetite. He reports having being exposed to many bugs while hiking through the swamps. The examination reveals conjunctival injection, facial flushing, and white coating of the tongue. The occipital, axillary, and inguinal lymph nodes are swollen, but non-tender. Spleen is palpable and liver extends 4cm beneath rib cage. Trunk is covered by a pale, roseolar, maculopapular rash. Examination of the
lungs, heart, ears, and nose do not show abnormalities. Blood pressure 130/80, temperature 38.9°C, pulse rate 105/min, and respiratory rate: 26/min. Blood tests: WBC: 3800/cm3, RBC: 4.9/pl, ESR: 30mm/h, CRP: 9.8mg/l. What is the most likely diagnosis?
A. Lyme disease
B. Rocky Mountain spotted fever
C. West Nile fever
D. African hemorrhagic fever
E. Malaria
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| sarika
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C. West Nile fever
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