Reference no: EM132761442

The sound of sizzling kawaling pinoy was following closely by an intoxicating aroma that filled the bustling waterfront eatery, mixing with the humid in air in a way that was at once appetizing and overwhelming. Gerald had been looking forward to enjoying this classic pork dish for months; friends had told him that Denicio's Harbor Square restaurant served the best one in all of Manila. His first visit to the Philippines had been a wild ride, filled with cheap food and drink, snorkeling, generic cigarettes, gambling and a panoply of highly anticipated vice. Ravenous, he tore into the tender porcine delicacy with his bare hands, covering his lips and face with seasoning and fat. He noticed that the meat inside was hardly even warm, and appeared noticeably pink and bloody. This only added to the flavor, and he was far too hungry to send it back to be cooked further. Sated by nearly a pound of the delicious pork tenderloin, he stood up and nearly fell over as the blood strained to migrate from his stomach to his head. Gerald concluded that this was indeed the best meal he had ever had, and made a mental note to seek out this treat every night for the remainder of his travels.

Friday, November 13th, 2015

Sitting at work in a comfortably air conditioned office building in Los Angeles, Gerald fondly daydreamed of the damp warmth that enveloped him like a blanket during his travels throughout the Philippines. He could still taste the savory kawaling pinoy. "Ahhhh, what a treat!", he mused to himself. "Ugh, what is that?" he groaned, as he fingered a hard and painful lump on his neck. Suddenly, he noticed several more scattered across his back and stomach. They were tender to the touch and varied in size. Gerald was horrified, but by the time he made an appointment to see his doctor a month later, the subcutaneous lumps had disappeared almost entirely. His doctor chalked it up to an allergic reaction that had resolved itself.

Monday, October 17th, 2016

At home in bed, Gerald was feeling delirious. He had been having headaches for weeks that seemed to be gradually increasing in frequency and intensity. Today he felt dizzy, his thinking was foggy, and there was a growing sense of pressure in his head. Feeling restless and upset, he wandered outside. People seemed to be avoiding him, walking across the street to stay away. Looking down, he realized that he had forgotten his pants and was wearing nothing but a t-shirt and socks. Then, as though someone had flipped a light switch, everything went dark. Gerald awoke in a hospital bed, feeling even worse than before. His doctor informed him that he had suffered a seizure and sent him for an MRI. The imaging tests showed large cyst-like lesions scattered throughout his cerebral parenchyma and significant abnormal accumulation of CSF (causing cerebral edema and severe headaches). Some were calcified, while others showed a small, dense looking larval organism.

-What disease is afflicting Gerald? What are the main symptoms that make this likely?

-Name and describe the pathogen that causes this disease.

-What could have been the source of Gerald's infection? How could the risk of this infection have been reduced or eliminated?

-Laboratory tests showed an elevated concentration of a specific type of white blood cell in Gerald's blood. Which leukocyte would this be, and what function does it serve?

-At this stage in his infection, what treatment would likely be prescribed? What interventions may be necessary?

-What is the mechanism of action of the treatment?