A 30-year-old woman presents with a 4-day history of extreme vulvar pruritus and vaginal discharge. The discharge is thick and white, moderate in amount, without associated foul odor. Her PMH is significant for poorly controlled diabetes for 2 years. On external exam, the vulva is erythematous with excoriations and presence of white plaques on the vaginal walls. The diagnosis was confirmed by examination of the wet-mount preparation of the discharge. Which of the following interventions is the most appropriate treatment for this patient?

The patient is a 30-year-old male who presents to the Emergency Department with a recent travel history to Africa where he spent 6 months as a Peace Corps Volunteer in Uganda. His chief complaint is fevers, headache, myalgias, and shaking chills. T 39.6°C (103.3°F). The patient was admitted for observation and further work-up. The patient had documented episodes of fever and chills approximately 3 times a day. Based on this information, which of the following laboratory tests would confirm your diagnostic suspicion?

Clinical manifestations of botulism typically include a descending symmetric flaccid paralysis.

A woman presents to your office after a 6-month sabbatical during which she worked in caves in the eastern part of South America. The patient reports fever, chills, productive cough, and joint stiffness that started 1 month before her return. Physical exam reveals 3 ulcerated lesions on her inner cheek. Which of the following is the most appropriate treatment for this patient?

A 4-year-old boy develops fever and an upper respiratory infection in late December. On physical examination, the pediatrician notes whitish spots in his mouth near his second molars (see image below). A day later the boy develops a rash on his face. The rash consists of reddened macules and papules. Within the next several days, the rash becomes confluent and moves downward over his whole body. Which of the following interventions would be most helpful in confirming the diagnosis of this condition? 

This type of atypical mycobacterium is found in fresh water or salt water; infection occurs following exposure of a skin or soft tissue injury to the organism, often in a fish tank or other marine animal setting, and typically results in granuloma formation.

A 54-year-old male with HIV presents to the Emergency Department with worsening dry cough, now with increasing shortness of breath. He is currently on antiretroviral therapy. On exam, his temperature is 98.4°F (36.9°C), blood pressure is 124/83 mmHg, pulse is 110/min, respirations are 24/min, and oxygen saturation is 91% on room air. Diffuse crackles are present upon auscultation of bilateral lungs. His most recent CD4 cell count is 140/mm3 and an arterial blood gas reveals a PaO2 of 60 mmHg. CXR is noted to have extensive interstitial infiltrates. Which of the following is the most appropriate treatment for the patient at this time?

Which of the following statements regarding diphtheria is TRUE?

Infection with this organism is acquired by inhalation; disseminated disease may involve any organ, though CNS involvement predominates; treatment generally includes amphotericin B and fluconazole.

A 6-year-old female becomes ill. She has a high fever and joint pain. Her joints become red, swollen, and warm. Her knee joint is involved initially, but then her ankle joint becomes involved. Her mother takes her to her pediatrician. On physical examination, she is found to have a heart murmur. She is also found to have firm, painless nodules on her elbows. Her doctor orders several laboratory tests and an EKG. Her laboratory results are as follows: TEST RESULTS REFERENCE RANGE Hematocrit 39 35-45 (age 6-12) Hemoglobin 13.9 gm/dL 11.5-15.5 gm/dL (age 6-12) Mean corpuscular volume 83 cu μ 77-95 cu μ (age 6-12) WBC 16.9 x 103/mm3 5.5-15.5 x 103/mm3 (age 4-7) RBC 4.1 x 106/μl 3.7-5.2 x 106/μl (age 2-14) ESR 41 mm/hr