A 48-year-old homeless man presents with recurring fevers (38.9°C), headache, and shin pain for 2 weeks. Vital signs show BP 128/82, HR 102, RR 18, SpO2 98%. He reports poor hygiene and multiple pruritic excoriations on his trunk. Examination reveals body lice in clothing seams. Labs show WBC 11,200/μL with left shift. He denies rash or joint pain. Which organism most likely causes his symptoms?

  1. A)Rickettsia prowazekii
  2. B)Coxiella burnetii
  3. C)Treponema pallidum
  4. D)Bartonella quintanaGABARITO
  5. E)Bartonella henselae

Explicação

Bartonella quintana is correct. Trench fever presents with recurrent fever and bone pain, especially in people with body louse exposure and unstable housing. The epidemiology is the key discriminator in this vignette. Ver explicação completa e trilha adaptativa →

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