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Antitoxin should ideally be administered within 24 hours of onset of signs or symptoms of this illness, in order to arrest progression of disease.

An 84-year-old female is brought to the Emergency Department by ambulance for intermittent fevers over the last two days. A caretaker at her nursing home reports that the patient has had new-onset incontinence and foul-smelling urine during the past week. They also state that the patient has been more confused than usual during this time. She has a medical history significant for Alzheimer dementia, hypertension, diabetes mellitus, and hyperlipidemia. Her temperature is 98.6°F (37°0F), pulse is 96, blood pressure is 90/60 mmHg, respirations are 24/min. Laboratory studies are obtained and demonstrate a leukocyte count of 11,500. Which of the following aspects of this patient’s presentation meets criteria for the systemic inflammatory response syndrome (SIRS)?

Systemic Inflammatory Response Syndrome (SIRS) defines a clinical response to a nonspecific insult of either infectious or noninfectious origin and may be caused by ischemia, inflammation, trauma, infection, or several insults combined.

Clinical manifestations of botulism typically include a descending symmetric flaccid paralysis.

A 3-year-old boy is admitted to the Emergency Department in acute respiratory distress. The patient has T: 40°C (104°F), RR: 70/min, and HR:130/min. Auscultation of the lungs is unremarkable. An examination of the throat reveals an exudate in the posterior pharynx that is yellowish and membranous. Bleeding occurs when it is scraped and removed. The parents of the child reveal that the child has received no prior immunizations. A throat culture was ordered and worked up specifically for an organism that selectively grows on cystine tellurite agar. What organism is causing this child’s disease?

The causative organism for syphilis is _____________________.

A 4-year-old girl presents with a 2-day history of muscle weakness. Her parents state she has stopped walking, and she tells them her legs feel “loose.” Two weeks ago, she had mild flu-like symptoms, including fever, sore throat, headache, and fatigue. Her family is seeking asylum from West Africa. Her vitals are blood pressure 110/78 mm Hg, heart rate 64 bpm, respiratory rate 15 breaths/min, and temperature 98 °F (36.7 °C). The physical examination demonstrates asymmetric proximal muscle weakness in the lower extremities and the absence of reflexes. Polymerase chain reaction confirms the suspected diagnosis. A vaccine would have prevented this child’s condition. Which of the following is a component of this vaccine?

Which of the following statements regarding diphtheria is TRUE?

A 30-year-old woman presents with a 4-day history of extreme vulvar pruritus and vaginal discharge. The discharge is thick and white, moderate in amount, without associated foul odor. Her PMH is significant for poorly controlled diabetes for 2 years. On external exam, the vulva is erythematous with excoriations and presence of white plaques on the vaginal walls. The diagnosis was confirmed by examination of the wet-mount preparation of the discharge. Which of the following interventions is the most appropriate treatment for this patient?

A 4-year-old boy develops fever and an upper respiratory infection in late December. On physical examination, the pediatrician notes whitish spots in his mouth near his second molars (see image below). A day later the boy develops a rash on his face. The rash consists of reddened macules and papules. Within the next several days, the rash becomes confluent and moves downward over his whole body. Which of the following interventions would be most helpful in confirming the diagnosis of this condition?