In August, a 30-year-old man presents with an ulcer on his leg with swelling of the lymph nodes in the surrounding area. He reports taking numerous hikes in the woods behind is house hunting rabbits. He does not recall any animal bites. What disease should be considered in the differential diagnosis?

Question

Quizplus · Accepted Answer

The presentation of an ulcer with swelling of the lymph nodes in the surrounding area after being in wooded areas where rabbits may be present is suggestive of tularemia, also known as rabbit fever. This bacterial infection is commonly acquired through contact with infected animals, such as rabbits or ticks, but can also occur through inhaling contaminated dust or drinking contaminated water. Lyme disease can also be acquired through tick bites in wooded areas, but typically presents with a characteristic "bull's eye" rash and flu-like symptoms. Brucellosis is typically associated with exposure to infected animals or consuming contaminated animal products, and would not necessarily present with an ulcer. Rat bite fever is also associated with exposure to infected animals, but typically presents with fever and rash, rather than an ulcer.

In August, a 30-Year-Old Man Presents with an Ulcer on His