A 52-Year-Old Woman Comes to the Physician Because of Progressively

A 52-year-old woman comes to the physician because of progressively worsening shortness of breath on exertion and fatigue for the past 4 months. Two years ago, she came to the office with dysphagia and underwent an upper endoscopy, which showed a dilated esophagus. There is no family history of serious illness. She emigrated from Argentina 5 years ago. She has smoked one pack of cigarettes daily for 25 years. She does not drink alcohol or use illicit drugs. She is 160 cm (5 ft 3 in) tall and weighs 62 kg (137 lb) ; BMI is 24 kg/m2. Temperature is 37.1ºC (98.8ºF) , pulse is 105/min, respirations are 15/min, and blood pressure is 110/62 mm Hg. Examination shows jugular venous distension. Cardiac examination discloses an S3 gallop and a displaced left ventricular impulse. The remainder of the examination shows no abnormalities. ECG shows left ventricular hypertrophy. Echocardiography shows right and left ventricular dilation and global hypokinesis. If this patient's symptoms are caused by an infection, which of the following organisms is the most likely cause?

A) Candida albicans
B) Clostridium botulinum
C) Cytomegalovirus
D) Helicobacter pylori
E) Schistosoma mansoni
F) Trypanosoma cruzi