USMLE Question #614: Real Exam Question with Answer & Explanation

The correct answer is D. poorly cooked pork. This patient has AIDS which predisposes him to opportunistic infections such as toxoplasmosis. The classic presentation of the reactivation of toxoplasmosis in AIDS patients is the presence of brain abscesses which are seen as multiple ring enhancing lesions on a MRI. Toxoplasma

Question

A 30-year-old Caucasian male with HIV/AIDS develops right-sided weakness involving his right leg. A MRI of his brain reveals multiple ring enhancing lesions within the white matter in his left frontal lobe. The most likely source of this infection in the United States is

Options

AAnopheles mosquito bite
Bbird droppings
Ccooling systems
Dpoorly cooked pork
Erodent droppings

Explanation

This patient has AIDS which predisposes him to opportunistic infections such as toxoplasmosis. The classic presentation of the reactivation of toxoplasmosis in AIDS patients is the presence of brain abscesses which are seen as multiple ring enhancing lesions on a MRI. Toxoplasma gondii is a protozoan which infects humans who ingest the oocysts from cat feces or improperly cook lamb or pork. Although cats are the necessary definitive host, the most common source of infection in the United States is poorly cooked pork. Immunocompromised hosts and fetuses are vulnerable to severe infection. In the fetus, toxoplasmosis causes extensive damage to the brain parenchyma and retina. Treatment is with sulfadiazine and pyrimethamine. In AIDS patients, the most frequent causes of ring enhancing lesions are primary brain lymphoma and toxoplasmosis.

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