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THE CASE: Cameron is an active 27-year old African-American veterinary technician who went to her family physician in Virginia in August of last year. She complained of extreme fatigue, headaches, and

extensively sore joints. She had several large, red circular rashes on her arms as well as multiple cuts, scrapes, bruises, and bug bites. Since Cameron is an avid competitor in extreme wilderness activities such as Eco-Challenges (multiple-day strength and endurance challenges) and Geocaching (wilderness treasure hunting using GPS satellite technologies), the doctor suspected that she was just physically run down and dehydrated from her recent outdoor competition in Golden, Colorado. He gave her prescriptions for sleep medication, hydration therapy, and a word of advice to "slow down" for a while. Two weeks later Cameron returned to the physician, her symptoms had gotten worse. She was barely able to walk due to swelling and pain in her knees, she had a high fever, and reported sudden difficulty controlling the muscles on the right side of her face. Further examination also discovered a faint heart arrhythmia. The doctor was alarmed and ordered a round of blood tests. 1. Before the blood tests were in, the doctor asked Cameron one significant question and upon hearing the answer, was sure he knew what was causing her symptoms. What could this question have been? Name 2 pathogens that could be involved in this case. Based on the signs and symptoms presented, what pathogen is most likely affecting Cameron? Would a Gram stain be helpful to this diagnosis? 4. Describe the morphology of this pathogen. 5. What is the clinical name for her condition? Where did the name for this disease come from? 6. Name the standard procedure that should be preformed to concretely confirm the doctor's suspicions (explain how this procedure works) 7. How is this disease most commonly contracted? (be specific in listing possible vectors) 2. 3. 8. Describe several ways to Cameron could have reduced the risk of contracting this disease. 9. Is there a vaccine that could have prevented this infection? 10. Should Cameron's husband Michael be tested for this disease?

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