A 27-year old white female presented at the walking clinic ofher local physician on August 15. On physical exam, the patient hada fever of 38.5C. She appeared fatigued, had tender joints, andcomplained of a headache, a stiff neck and a backache. Thephysician noticed a circular “rash” about 5 inches in diameter,with a bright red leading edge and a dim center in the form of a”bull’s eye”. The physician noted an irregular heart beat. Thepatient complained of lack of ability to concentrate. The patientgave the following history: She is a graduate student in thewildlife program at the university in town. She was in the fieldfor three weeks in Wisconsin during the months of May and June. Shetracks small mammals in the field and studies their behavior. Ithad been a warm, wet spring and she complained of a large number ofbiting flies, mosquitoes and ticks in the area. She felt well untilabout 2 weeks after returning to her home. Since that time, many ofher symptoms had progressed. She finally found that she could takeit no more. What is your best diagnosis of this case? What featuresare critical to your diagnosis? Which diagnostic procedures/testswould you run to confirm your diagnosis? What further steps shouldbe taken to clear up the problem in this patient? Your essay shouldbe approximately 2 pages in length, double-spaced in 10-12 pointfont. Please be sure to cite all sources of information, includingthe text book, in the essay text and on a reference page using APAformat. When you have finished your essay, attach it to theassignment drop box and submit it to your instructor. Compose yourwork in a .doc or .docx file type using a word processor (such asMicrosoft Word, etc.) and save it frequently to your computer. Forthose assignments that are not written essays and require uploadingimages or PowerPoint slides, please follow uploading guidelinesprovided by your instructor. Check your work and correct anyspelling or grammatical errors. When you are ready to submit yourwork, click “write Submission” to compose in the body.
