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A 31-Year-Old Man Is Brought to the Emergency Department After

Question 253

Multiple Choice

A 31-year-old man is brought to the emergency department after a tonic-clonic seizure.  The patient has no known medical conditions.  He grew up in a rural part of Guatemala and immigrated to the United States 3 years ago.  The patient works as an architect and owns a cat.  He has no history of tuberculosis.  On examination, the patient is afebrile and has no focal neurologic deficits or meningeal signs.  HIV antibody test and interferon-gamma release assay are negative.  Chest x-ray is normal.  MRI of the head reveals a 1.5-cm cyst within the left sylvian fissure that has minimal enhancement and no associated edema.  Which of the following is the most likely means of acquisition of the infection responsible for this patient's findings?


A) Absorption through the skin of the feet
B) Exposure to infected stool
C) Handling of a cat litter box
D) Inhalation of fungal spores
E) Scratch from a cat
F) Sexual transmission

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