A 56-year-old man complained of progressive fatigue and malaise. His physical examination was generally satisfactory, with a pulse of 90 beats per minute, and multiple lymphadenopathy and...

A 56-year-old man complained of progressive fatigue and malaise. His physical examination was generally satisfactory, with a pulse of 90 beats per minute, and multiple lymphadenopathy and hepatomegaly. No bacteria were found in cerebrospinal fluid smears of lumbar puncture, but a flagellum, elongated nucleus with blue and red cytoplasm were found in the blood by Giemsa staining of thin blood smears. The family reported that the patient had been engaged in transportation business in Africa for many years.

1. What do you think is the most likely disease for this patient?

• Malaria


• Dengue fever


• African sleeping disease


• Toxoplasma encephalitis


• Bacterial meningitis

2. What do you think is the most likely pathogen for this patient?

• Plasmodium vivax


• Toxoplasma gondii


• Plasmodium falciparum


• Plasmodium malariae


• Trypanosoma brucei gambiense

3. What do you think is the most direct basis for the diagnosis of the pathogen?

• From Africa


• Fatigue


• Hepatomegaly


• Special structure was found on blood smear


• Enlarged lymph nodes