Question

A veterinary radiologist presents to the emergency room with a 4-week history of headache, vague fever, and paresthesias in the fingers and toes. His temperature is 103.5° F (39.7° C). He complains of difficulty swallowing with pharyngeal spasms for the past 3 days. The most likely diagnosis is:

A. West Nile virus infection
B. Tetanus infection
C. Acute botulism
D. Rabies
E. Epstein-Barr virus infection

Answer 1

The veterinary radiologist is most likely suffering from Rabies, characterized by hydrophobia, high fever, and neurological symptoms, which align with his clinical presentation and occupational risk.

Step-by-step explanation:

The most likely diagnosis for a veterinary radiologist who has a history of headache, fever, paresthesias, difficulty swallowing with pharyngeal spasms, and a high temperature of 103.5° F (39.7° C) is Rabies. The difficulty swallowing and spasms, known as hydrophobia, when associated with a high fever and neurologic symptoms, are hallmark features of rabies, particularly when there is an occupational or situational risk factor present such as exposure to animals. For diagnostic verification, tests like skin biopsies, immunofluorescent staining for antibodies, and samples of blood and saliva would be essential to detect the presence of the rabies virus.