Final diagnoses

1) Murine typhus

Causative microorganism: Rickettsia typhi

Transmission vehicles: Lice or fleas

How we deduced: It is highly probable as the patient is living in unhygienic conditions and there is also an infestation of fleas. Moreover, the patient feeds stray dogs and cats which could have fleas carrying Rickettsia typhi.

Sample(s) taken: Blood

Collection via: Venipuncture (venous blood)

Preliminary testing: Full blood count, Blood culture

Confirmatory testing: Direct Fluorescent Antibody (DFA), Skin rash biopsy


2) Lyme disease

Causative microorganism: Borrelia burgdorferi

Transmission vehicles: Rodent ticks

How we deduced: The infestation of rats in his premise makes the probability of contracting lyme disease a reality for the patient.

Sample(s) taken: Blood

Collection via: Venipuncture (venous blood)

Preliminary testing: Physical investigations for visible rash, ELISA to detect lyme antibodies

Confirmatory testing: Lyme disease testing (Anti-borrelia burgdorferi IgM/IgG), Western Blot, Polymerase Chain Reaction (PCR)