WBR1500

Author	PageAuthor::William J Gibson
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Microbiology
Sub Category	SubCategory::General Principles, SubCategory::Infectious Disease
Prompt	[[Prompt::A 35-year-old male presents to his primary care physician for muscular pain, sweating and fever over the past five days. He reports that his fever tends to increase throughout the day and falls at night. The patient denies any recent travel to foreign countries, or new sexual partners. He works as a goat farmer and hunts deer on the weekends. Physical exam is notable for cervical lymphadenopathy. If untreated, which of the following complications is most likely?]]
Answer A	AnswerA::Meningitis
Answer A Explanation	AnswerAExp::The waxing/waning fever in this patient heavily implicates Brucella infection. Meningitis has been reported as a very rare complication of brucellosis, but it is not considered a common feature of infection.
Answer B	AnswerB::Orchitis
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::Myocarditis
Answer C Explanation	AnswerCExp::Myocarditis is a common complication of another zoonotic infection, Lyme disease.
Answer D	AnswerD::Endocarditis
Answer D Explanation	AnswerDExp::
Answer E	AnswerE::Osteomyelitis
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::E
Explanation	[[Explanation::The patient in this vignette has a classic case of undulating fever, caused by infection with Brucella species. Brucellosis is a highly contagious zoonotic infection that is most commonly associated with ingestion of unpasteurized dairy products or undercooked meat. Exposure to products from goats is especially associated with brucellosis. Educational Objective: Undulating fever is caused by infection with Brucella species. References: ]]
Approved	Approved::No
Keyword	WBRKeyword::Microbiology, WBRKeyword::Zoonotic, WBRKeyword::Bacteria, WBRKeyword::Fever, WBRKeyword::Brucella
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::