A 6-week-old infant is hospitalized with RSV bronchiolitis, presenting with tachypnea, audible wheezing, and hypoxemia. The underlying pathophysiology responsible for the small airway obstruction and subsequent respiratory distress in this infant is best described as which of the following?
A child is diagnosed with Stage 1 Gambian human African trypanosomiasis and is treated with pentamidine. Which of the following is a significant adverse effect that requires careful monitoring during pentamidine therapy?
A 6-year-old girl who recently immigrated from a rural area in Mexico presents with a 3-week history of daily fevers, arthralgia, and fatigue. Her family regularly consumes unpasteurized goat cheese. A diagnosis of uncomplicated brucellosis is made. What is the recommended first-line oral antimicrobial regimen for this child?
A 5-year-old girl with acute lymphoblastic leukemia has invasive candidiasis. Her initial therapy with an echinocandin results in a good clinical response. The team wants to transition to an oral agent as she is now stable and not critically ill. Which of the following is an acceptable step-down therapy?
A 15-year-old with perinatally acquired HIV who is on a stable cART regimen presents for a routine visit. Laboratory monitoring reveals that his plasma HIV RNA level has increased from undetectable to 1,500 copies/mL on two consecutive measurements taken a month apart. The patient admits to frequently forgetting to take his medications. What is the most appropriate next step to guide a potential change in therapy?
A 7-year-old child living in a rural community with poor sanitation presents with chronic dysentery and rectal prolapse. A stool examination reveals characteristic barrel-shaped ova. What is the most likely causative organism?
A 9-year-old boy presents to the clinic with a deep puncture wound on his foot from a rusty nail sustained while playing in a barn 2 days ago. His immunization history is uncertain, but his mother believes he may have received 1 or 2 doses of tetanus-containing vaccine as a baby. The wound has been cleaned. What is the most appropriate management for tetanus prophylaxis?
A 9-month-old infant presents with persistent fever, hepatosplenomegaly, and pancytopenia. He lives in an area endemic for histoplasmosis. A bone marrow aspirate shows yeast forms within macrophages, confirming disseminated histoplasmosis. What is the appropriate initial therapy for this severe form of the disease?
A 2-month-old infant presents with an enlarging head circumference and chorioretinitis on fundoscopic exam. The mother recalls having a “flu-like” illness during her second trimester and notes that mice are frequently seen in their house. A head CT is ordered. Which constellation of findings would be a hallmark of congenital lymphocytic choriomeningitis virus (LCMV) infection?
An 18-month-old infant is brought to the clinic because the mother has noticed small, white, “rice grain-like” segments in the diaper. The family has a dog that recently had fleas. The child is otherwise asymptomatic. This presentation is most consistent with which tapeworm infection?
