Nokea
A 25-year-old patient was delivered to an infectious diseases unit on the 3rd day of illness with complaints of headache, pain in lumbar spine and gastrocnemius muscles, high fever, chill. Objectively: condition of moderate severity. Scleras are icteric. Pharynx is hyperemic. Tongue is dry with dry brown coating. Abdomen is distended. Liver is enlarged by 2 cm. Spleen is not enlarged. Palpation of muscles, especially gastrocnemius muscles, is painful. Urine is dark in color. Stool is normal in color. The most likely diagnosis is:
Correct Answer: A
Rationale: The correct diagnosis is Leptospirosis. Leptospirosis presents with headache, fever, muscle pain, jaundice, and kidney involvement. The patient's symptoms of headache, lumbar and muscle pain, high fever, icteric scleras, and dark urine are classic for Leptospirosis. The enlarged liver could be due to liver involvement in the disease. The absence of splenic enlargement and normal stool color rule out malaria. Infectious mononucleosis typically presents with sore throat and lymphadenopathy, which are absent in this case. Viral hepatitis A may present with similar symptoms, but the presence of muscle pain and dark urine is more indicative of Leptospirosis. Therefore, based on the patient's symptoms and clinical findings, Leptospirosis is the most likely diagnosis.