Farm Animal Births in Medicine / Internal Medicine — 43yo Man | Infectious Diseases | SMLE Q#12134
SMLE Question #12134
Medicine / Internal Medicine
Infectious Diseases
Objective: OBJ-349
Last updated: February 2026
A 43-year-old male veterinarian has 2 months of progressive fatigue, intermittent evening fevers, and low back pain, followed by headaches, mood changes, and intermittent hand paresthesias. He frequently assists with farm animal births and consumes unpasteurized dairy products. Examination shows mild hepatosplenomegaly and right sacroiliac joint tenderness with limited motion; the neurologic exam is nonfocal but limited by poor cooperation. What is the most likely diagnosis?
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