2/ 28F HIV/HBV/HCV(-) SLE on MTX w chronic pain Rx as flare, vaginal discharge due to BV Rx metro (negative GC/chlamydia), skin rash x 2 w and progressive vision loss (photo). CXR clear. Indiana / no foreign travel. No animal exposures.
What is most likely diagnostic test?
3/ Case diagnosis: bilateral ocular syphilis with neurosyphilis
Syphilis antibody with reflex: positive
CSF VDRL 1:1
This is the histopath and gram stain of culture of a lymph node biopsy of a person with tender purulent inguinal adenopathy.
MCQ #MayoIDQ to follow
72M. Crohn’s. 2 pet dogs. 1 pet cat.
2 mo after L knee surgery —> tender L inguinal node with purulence. No F/C. No response to TMP-SMX.
Biopsy (see photo): Stellate suppurative granuloma with central necrosis and clumps of bacteria.
What is the most likely diagnosis?
1/ #Gram stain: a first step in bacterial identification —> two major groups: 1. Gram-positive: retains primary stain (crystal violet) 2. Gram-negative: does not retain crystal violet but counterstained by safranin/fuchsine —> red / pink
2y later: back pain
MRI (photo) + enhancement of graft + aneurysm
Surgery (photo): bacteria, fungi/TB cultures (-)
DIF with anti-Coxiella Ab in fibroblasts (photo).
In a 74M farmer with multilevel vertebral osteomyelitis and soft tissue abscess contiguous with vascular graft and mycotic aneurysm, which serological pattern is most consistent with a diagnosis of chronic Q fever? #MayoIDQ (PI phase 1; PII phase 2 titers)