Leptospira speciesDownloads

A 23-year-old woman presents with progressively worsening headache, photophobia, and intermittent fever that have lasted for 6 days. She says her headache is mostly frontal and radiates down her neck. She denies any recent history of blood transfusions, recent travel, or contact with animals. Her past medical history is unremarkable. She is sexually active with a single partner for the past 3 years. Her temperature is 38.5°C (101.3°F). On physical examination, she appears pale and diaphoretic. A fine erythematous rash is noted on the neck and forearms. A lumbar puncture is performed and CSF analysis reveals: Opening pressure: 300 mm H2O Erythrocytes: None Leukocytes: 72/mm3 Neutrophils: 10% Lymphocytes: 75% Mononuclear: 15% Protein: 100 mg/dL Glucose: 70 mg/dL Which of the following is the most likely diagnosis in this patient?

A 26-year-old immigrant from Mexico presents to your clinic for a physical. He tells you that several weeks ago, he noticed a lesion on his penis which went away after several weeks. It was nontender and did not bother him. He currently does not have any complaints. His temperature is 97.9°F (36.6°C), blood pressure is 139/91 mmHg, pulse is 87/min, respirations are 14/min, and oxygen saturation is 98% on room air. Physical exam is unremarkable and shows no evidence of any rash. A VDRL and FTA-ABS test are both positive. What is the most appropriate management of this patient?