Case Challenges

Quiz

203Infectious Diseases
A 22-year-old man presented to the hospital with fever for 4 days. He also complained of myalgia and sore throat. His blood pressure was 110/70 mmHg, pulse rate 90/min, respiratory rate 20/min, and body temperature 39.2 ℃. Multiple cervical lymph nodes were palpable bilaterally and were tender to touch. The lesions were as shown in Figure A. The blood test results were as follows. What is the appropriate treatment?
185Infectious Diseases
A 72-year-old man presented to the hospital with shortness of breath and cough that began 12 hours ago. He had developed cough, fever, and chills two days prior. He has not received any vaccinations, including COVID-19 vaccine, since adulthood. His vital signs were: blood pressure 90/40 mmHg, heart rate 110 beats per minute, respiratory rate 32 breaths per minute, and body temperature 39.5℃. On auscultation, coarse breath sounds were heard bilaterally. Diagnostic tests were performed, and a chest computed tomography (CT) scan is shown (Figure A).
What is the appropriate treatment?
161Infectious Diseases
A 19-year-old man presented to the hospital with a skin rash. He developed fever and malaise two days ago, followed by a rash that began on the face and trunk and rapidly spread across the entire body. His 8-year-old sibling, who lives with him, developed similar symptoms. His vital signs were: blood pressure 110/80 mmHg, heart rate 70 beats per minute, respiratory rate 20 breaths per minute, and body temperature 38.2℃. The skin lesions appeared as shown in Figure A.
What is the appropriate treatment?
155Infectious Diseases
A 54-year-old man presented with fever and back pain. The pain had acutely worsened the day before, to the point where he could no longer stand up. He reported experiencing occasional back pain in the past and had undergone acupuncture multiple times. His vital signs were: blood pressure 100/70 mmHg, heart rate 120 beats per minute, respiratory rate 20 breaths per minute, and body temperature 38.9℃. Lumbar spine MRI is shown (Figure A). Considering the Gram stain findings from a blood sample (Figure B), which antibiotic would be appropriate?
137Infectious Diseases
A 27-year-old man presented to the hospital with a painful, indurated swelling on the occipital scalp that began a week ago. This morning, purulent discharge began oozing from the area. He reported a habitual tendency to scratch his scalp due to frequent itching. He had been taking an antibiotic prescribed by a nearby clinic for the past four days, which was identified as cephradine (a first-generation cephalosporin). Which empirical antibiotic would be most appropriate to use before the culture results become available?
65Infectious Diseases
A 44-year-old man presented to the emergency department with high fever, vomiting, and diarrhea that began 4 days ago. He had returned from Guinea, West Africa 7 days ago, where he had been working as a welder for the past 2 months. On arrival, his vital signs were: blood pressure 70/40 mmHg, pulse 109 beats per minute, respiratory rate 20 breaths per minute, and temperature 39℃. Laboratory findings (Figure A) and a peripheral blood smear (Figure B) are provided.
What is the appropriate treatment?

46Infectious Diseases
A 20-year-old man presented to the hospital with fever as his chief complaint. He had recently returned from a trip to Laos two weeks prior. On physical examination, a skin rash was noted (Figure A), and laboratory results are shown in Figure B. What is the appropriate treatment?