A 51-year-old man was taken to his physician’s office with a one-week history of fever, headache, and muscle aches.

A 51-year-old man was taken to his physician’s office with a one-week history of fever, headache, and muscle aches. He had an ulcer on his right hand that had not healed and pain in his right armpit. He lived in Oklahoma and makes a living as a trapper, supplying furs to fashion designers in New York City. One week before his symptoms started, he had skinned and tanned a rabbit killed by the family dog. On physical exam he has an ulcerated lesion on his right thumb and a painful enlarged axillary lymph node in his right armpit. Cultures were taken of blood and needle biopsies of both the lesion and the enlarged lymph node. Tiny coccobacilli that were weakly Gram-negative were seen. The patient was treated with oral cephalosporin, but with no success. Seorologic tests were ordered. 1. What is the causative agent responsible for his symptoms? a. Bacillus anthracis b. Staphylococcus aureus c. Francisella tularensis d. Yersinia pestis 2. Which form of this disease does this patient have? a. Ocularglandular b. Ulceroglandular c. Orophangeal d. Gastrointestinal 3. Which route of transmission is most likely to have occurred for this patient? a. Ingesting infected meat b. Bite of infected