Q74
Single choice
A 37-year-old man visiting a third world country drinks from a fecally contaminated source of water. During the next week he has gradually increasing fever, anorexia, myalgia, and headache. He subsequently develops a maculopapular rash on his abdomen and his fever increases to 104°F with abdominal pain and splenomegaly. During the third week, his condition rapidly deteriorates with intestinal bleeding, shock, and death. An autopsy reveals ulcerations overlying the Peyer patches of the small intestine, one of which is perforated.
Which of the following is the most likely diagnosis?