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A 42-Year-Old Man Comes to the Office Due to 2

question 106

Multiple Choice

A 42-year-old man comes to the office due to 2 weeks of progressive fever, chills, abdominal discomfort, and loose stools, which began during a trip to Southeast Asia. He received no pre-travel vaccinations and did not strictly follow food and water safety precautions during the trip. The patient has no chronic medical conditions but has experienced a prior episode of Salmonella enteritidis gastroenteritis, which resolved with symptomatic care. Temperature is 39.4 C (103 F) , blood pressure is 110/64 mm Hg, pulse is 62/min, and respirations are 18/min. Physical examination reveals a faint macular rash on the trunk. There is mild tenderness on palpation of lower abdominal quadrants with no guarding or rebound tenderness. Blood culture grows non-lactose fermenting gram-negative rods. Which of the following best explains the prolonged and severe disease course from this pathogen compared to the patient's previous bacterial infection?

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Definitions:

Alcohol Abuse

Excessive drinking leading to health problems and negative social, emotional, or legal consequences.

Substance Abuse

The harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.

Terminal Illness

A disease or condition that cannot be cured and is expected to lead to the death of the patient within a short period of time.

Suicidal Act

A deliberate action with the intention to cause one's own death.