A 41-year-old veterinarian man presents with 3-month history of progressive fatigue, back pain, and fever. He also noticed a recent history of headache, mood behavior changes, and... A 41-year-old veterinarian man presents with 3-month history of progressive fatigue, back pain, and fever. He also noticed a recent history of headache, mood behavior changes, and paraesthesia. He does not smoke and has no history of alcohol or other significant medical history. On examination, he was uncooperative and agitated. Abdomen examination showed mild hepatosplenomegaly and tender right sacroiliac joint. Blood pressure is 110/70, heart rate is 36, and temperature is 38.6. Test results show: Platelets count 122, WBC 8.4. Which of the following is the most appropriate next step in management? A. Liver function B. X-ray sacroiliac C. Tuberculin skin test D. Tube aspiration.
Understand the Problem
The question presents a clinical scenario involving a 41-year-old man with a variety of symptoms, and it asks for the most appropriate next step in managing his case. The symptoms may indicate an underlying condition requiring specific diagnostic or management steps. The goal is to assess the best management option based on the presented patient's condition.
Answer
Tube aspiration
The final answer is Tube aspiration.
Answer for screen readers
The final answer is Tube aspiration.
More Information
The symptoms presented, such as progressive fatigue, back pain, fever, headache, and mood changes, along with the history of occupation as a veterinarian, suggest a potential infectious etiology like Brucellosis. Tube aspiration could be an appropriate diagnostic and therapeutic step for conditions involving abscess or joint effusion.
Tips
A common mistake might be choosing liver function tests or tuberculin skin tests without considering the occupational risk factors and symptomatology indicating an infectious disease, particularly one associated with veterinary work.
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