A 29-Year-Old Man Is Hospitalized Due to a Flulike Illness

A 29-year-old man is hospitalized due to a flulike illness.  His symptoms abruptly began 3 days ago with fever, rigors, malaise, headache, and myalgia.  The patient has no prior health conditions and is usually very active, participating in multiple outdoor sports.  Temperature is 38.9 C (102 F) , blood pressure is 124/84 mm Hg, and pulse is 110/min.  Physical examination shows an ill-appearing man with bilateral conjunctival suffusion.  Lung and heart sounds are normal, but abdominal examination reveals mild hepatosplenomegaly.  Generalized lymphadenopathy is also present.  A test for influenza antigen is negative, and blood cultures in routine growth media are negative.  The patient subsequently develops progressive jaundice and renal failure.  Further testing detects an infection with a highly motile, corkscrew-shaped pathogen.  This patient most likely acquired the infection via which of the following?

A) Being in close vicinity of infected bats
B) Bites from infected rodent fleas
C) Exposure to water contaminated with animal urine
D) Hiking in tick-infested wooded areas
E) Hunting and skinning of wild rabbits

Correct Answer:

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