A 2-year-old girl is admitted to the pediatric intensive care unit with rapid progression to noncardiogenic pulmonary edema, cardiopulmonary failure, and coma. She had been diagnosed with hand-foot-and-mouth disease one week prior. An MRI shows brainstem encephalitis. This severe presentation is a well-described complication of which enterovirus?
A 15-year-old boy who enjoys eating raw freshwater fish ceviche while on vacation in Southeast Asia develops intermittent, migratory, nonpitting edema on his arm associated with pain and pruritus. What is the most likely diagnosis?
A family returns from a camping trip in New Mexico. Two days later, their 10-year-old son develops high fever, dyspnea, and hemoptysis, and a diagnosis of primary pneumonic plague is made. The parents and an asymptomatic 8-year-old sibling were in close, direct contact with the patient. What is the most appropriate management for the asymptomatic 8-year-old sibling?
A 29-week premature infant in the NICU develops progressive hydrocephalus and meningitis. Bacterial cultures of the cerebrospinal fluid are negative. A PCR test on the CSF is positive for Mycoplasma hominis. Which of the following systemic antibiotics would be LEAST effective for treating this infant’s infection?
A 12-year-old child with HIV is managed on a regimen that includes the pharmacokinetic booster ritonavir. He develops new-onset wheezing and is diagnosed with asthma. His primary care provider is considering prescribing an inhaled corticosteroid. Co-administration of ritonavir with which of the following common asthma medications requires extreme caution due to a significant drug-drug interaction?
A 12-year-old previously healthy girl is brought to the emergency department in August with a sudden onset of severe headache, fever, and altered mental status. She has a history of swimming in a warm freshwater lake 5 days ago. A wet mount of her cerebrospinal fluid (CSF) shows motile amebae. In addition to intravenous amphotericin B and aggressive management of intracranial pressure, which novel agent is now a key component of the recommended combination therapy for primary amebic meningoencephalitis?
A 17-year-old with cystic fibrosis develops a severe necrotizing pneumonia and sepsis. Sputum cultures grow Burkholderia cenocepacia that is resistant to meropenem, ceftazidime, and trimethoprim-sulfamethoxazole. Which newer agent has demonstrated activity against some of these highly resistant isolates due to its enhanced stability against various β-lactamases, including metallo-β-lactamases and carbapenemases?
A 16-year-old male who has sex with men presents to a gastroenterologist with a 4-week history of rectal pain, discharge, and tenesmus, which has been mistaken for inflammatory bowel disease. A nucleic acid amplification test from a rectal swab is positive for Chlamydia trachomatis. Given the high index of suspicion for lymphogranuloma venereum (LGV) proctocolitis, what is the most appropriate treatment regimen?
A pregnant woman at 18 weeks of gestation has a primary parvovirus B19 infection. An ultrasound is performed to assess fetal well-being. What is the primary mechanism leading to nonimmune fetal hydrops in this setting?
A child living in the Far East presents with abdominal pain, diarrhea, and signs of malabsorption. The family’s diet includes raw aquatic plants from a local pond. Stool examination reveals large, operculated eggs. Which intestinal fluke is the most probable cause?
