A 7-year-old child, recently immigrated from a country with endemic tuberculosis, has a positive interferon-γ release assay (IGRA) and is started on isoniazid for latent tuberculosis infection. The child follows a strict vegan diet. Which of the following should be co-administered with isoniazid to prevent a potential dose-related adverse effect?
A 6-week-old infant who was born at 26 weeks gestation has a severe Candida diaper dermatitis that is not responding to topical nystatin. The infant has also had several courses of broad-spectrum antibiotics. Which of the following findings would most strongly warrant the initiation of systemic antifungal therapy?
A researcher is comparing the cellular tropism of Human T-cell leukemia virus 1 (HTLV-1) and Human T-cell leukemia virus 2 (HTLV-2) by analyzing infected peripheral blood mononuclear cells. The analysis is most likely to confirm that HTLV-1 has a known preference for infecting CD4+ T-cells, while HTLV-2 preferentially infects which cell type?
A 10-year-old girl presents with a first-time generalized seizure after immigrating from Honduras. An MRI of the brain reveals two parenchymal cysts with visible scolices, consistent with neurocysticercosis. In addition to antiepileptic drugs, what is the standard adjunctive therapy that should be administered with antiparasitic agents like albendazole?
A 4-year-old healthy girl presents with a 6-week history of a slowly enlarging, non-tender, firm 3-cm lymph node in the right submandibular region. The overlying skin has recently developed a violaceous hue. A tuberculin skin test is 8 mm of induration and a chest radiograph is normal. What is the most effective and preferred treatment for this condition?
A 10-year-old child presents with a fixed cutaneous lesion on her hand after being scratched by a rose bush. The culture grows Sporothrix schenckii. She is started on oral itraconazole but develops significant nausea and vomiting. What is a suitable alternative therapy for her cutaneous-only disease?
An 8-year-old boy living in a high-poverty area of Appalachia presents with vague abdominal complaints. During a coughing fit, he expels a large, 15-cm roundworm. Microscopic examination of his stool is likely to reveal which characteristic finding?
A 10-year-old child develops severe headache, neck stiffness, and migrating paresthesias after eating raw snails on a dare during a trip to Hawaii. A lumbar puncture shows pleocytosis with 20% eosinophils. While treatment is primarily supportive, what is the rationale for avoiding anthelmintic drugs in eosinophilic meningitis caused by Angiostrongylus cantonensis?
A 4-year-old is diagnosed with invasive Neisseria meningitidis disease after presenting with fever and a petechial rash. His 18-month-old unvaccinated sibling, who attends the same daycare, is asymptomatic but was in close contact. What is the most appropriate management for the sibling?
A 10-year-old child with chronic pulmonary histoplasmosis is prescribed itraconazole capsules. To enhance the dissolution and absorption of this specific formulation, what advice should be given to the patient and his parents?
