Question: An 82-year-old Woman Is Brought Into The Clinic With The Following Symptoms: Headache, Fever, Malaise, And Excessive Fatigue. She Also Has Some Blisters On Her Arms That Appear To Be Associated With Scratches Caused By Her Pet Cat. She Says That She Has Had The Blisters For 2 Or 3 Weeks, And That The Other Symptoms Have Appeared Only More Recently. …

An 82-year-old woman is brought into the clinic with the following symptoms: headache, fever, malaise, and excessive fatigue. She also has some blisters on her arms that appear to be associated with scratches caused by her pet cat. She says that she has had the blisters for 2 or 3 weeks, and that the other symptoms have appeared only more recently. Closer examination also reveals a swelling of the lymph nodes in the armpits and a blood test reveals the presence of gram-negative bacilli. Discussion 1. On the basis of the circumstances, symptoms, and results of examination and tests, discuss the probable disease and the causative pathogen(s). 2. Discuss the preventive measures and treatment for older patients with potentially compromised immune systems. I