A 34-year-old man comes to the physician for a 2-month history of an itchy rash on his forearm. He feels well otherwise and has not had any fever or chills. He returned from an archaeological expedition to Guatemala 4 months ago. Skin examination shows a solitary, round, pink-colored plaque with central ulceration on the right wrist. There is right axillary lymphadenopathy. A photomicrograph of a biopsy specimen from the lesion is shown. Which of the following is the most likely causal organism?
ATreponema pallidum
BBorrelia burgdorferi
CTrypanosoma brucei
DAncylostoma duodenale
ELeishmania braziliensis
A 32-year-old woman presents to your office with abdominal pain and bloating over the last month. She also complains of intermittent, copious, non-bloody diarrhea over the same time. Last month, she had a cough that has since improved but has not completely resolved. She has no sick contacts and has not left the country recently. She denies any myalgias, itching, or rashes. Physical and laboratory evaluations are unremarkable. Examination of her stool reveals the causative organism. This organism is most likely transmitted to the human host through which of the following routes?
AInsect bite
BPenetration of skin
CSexual contact
DInhalation
EAnimal bite
A 48-year-old man comes to the physician because of a hypopigmented skin lesion on his finger. He first noticed it 4 weeks ago after cutting his finger with a knife while preparing food. He did not feel the cut. For the past week, he has also had fever, fatigue, and malaise. He has not traveled outside the country since he immigrated from India to join his family in the United States 2 years ago. His temperature is 38.7°C (101.7°F). Physical examination shows a small, healing laceration on the dorsal aspect of the left index finger and an overlying well-defined, hypopigmented macule with raised borders. Sensation to pinprick and light touch is decreased over this area. Which of the following is the most likely causal pathogen of this patient's condition?
AEpidermophyton floccosum
BMycobacterium leprae
CMalassezia furfur
DPseudomonas aeruginosa
ELeishmania donovani
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