A 22-Year-Old Student Comes to the Physician Complaining of 4

A 22-year-old student comes to the physician complaining of 4 days of fever, double vision, and painful swelling around his eyes.  He also has significant muscle pain in his neck and jaw muscles.  Two weeks ago, the patient returned from a trip to central Mexico.  One week after his return, he developed abdominal pain, nausea, vomiting, and diarrhea.  These symptoms resolved spontaneously.  He has a history of intravenous drug abuse but recently completed a drug rehabilitation program.  His temperature is 38.3 C (101 F) , blood pressure is 110/70 mm Hg, pulse is 92/min, and respirations are 14/min.  Physical examination shows subungual splinter hemorrhages, periorbital edema, and chemosis.  Lungs are clear to auscultation.  Cardiac examination shows no murmurs.  The abdomen is soft and nontender without organomegaly.  Laboratory results are as follows: Which of the following is the most likely diagnosis?

A) Ascariasis
B) Dengue fever
C) Giardiasis
D) Infective endocarditis
E) Trichinellosis
F) Typhoid fever

Correct Answer:

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