A 37-year-old male was admitted to a hospital complaining of abdominal pain, difficulty in swallowing and breathing, constipation, and nausea. He developed respiratory failure and required endotracheal intubation and ventilation. Two days before, the patient consumed dried salted fish bought from an artisanal producer. Laboratory investigation for infectious pathogen was performed using Kitt-Tarozzi's method. Observation under a bright field microscopy revealed the presence of typical microorganisms with tennis racket appearance. Which of the following is the most likely diagnosis?

Correct Answer: A

Rationale: The correct answer is A: Botulism. Botulism is caused by the toxin produced by Clostridium botulinum bacteria found in improperly preserved or canned foods. The symptoms described align with botulism, such as difficulty swallowing and breathing due to muscle paralysis. The tennis racket appearance seen under microscopy corresponds to the characteristic appearance of Clostridium botulinum spores. The other choices can be ruled out based on the clinical presentation and microscopy findings. Cholera typically presents with severe watery diarrhea, Nontyphoidal Salmonella infection with fever and gastrointestinal symptoms, and Typhoid fever with high fever and abdominal pain. Therefore, the most likely diagnosis in this case is botulism.

Correct Answer: C

Rationale: Rationale: Metronidazole is the drug of choice for systemic amebiasis due to its high efficacy against Entamoeba histolytica. It has good tissue penetration and can treat intestinal, liver, and lung involvement. Quiniofone (A) has limited use and is not recommended for amebiasis. Enteroseptol (B) is not effective against systemic amebiasis. Tetracycline (D) is not the first-line treatment for amebiasis and has limited efficacy against Entamoeba histolytica.

Correct Answer: A

Rationale: Rationale: The correct answer is A: Trichomonas vaginalis. 1. Symptoms of urogenital inflammation match Trichomonas vaginalis infection. 2. Description matches Trichomonas vaginalis characteristics: pear-shaped, pointed spike, big nucleus, undulating membrane. 3. Trichomonas hominis and buccalis do not typically infect urogenital tracts. 4. Trypanosoma gambiense causes African trypanosomiasis, not urogenital infections.

Correct Answer: D

Rationale: The correct answer is D: Primaquine. Primaquine is used for individual chemoprophylaxis of malaria caused by Plasmodium vivax and Plasmodium ovale. It is effective in preventing the relapse of these malaria species by eliminating the liver forms of the parasites. Chingamin (A) is not a commonly used drug for malaria prophylaxis. Pyrantel (B) is an anthelmintic drug used for treating parasitic worm infections, not malaria. Pyrimethamine (Chloridinum) (C) is primarily used in combination with sulfadoxine for treating uncomplicated malaria, not for chemoprophylaxis.

Correct Answer: C

Rationale: The most probable diagnosis for the homeless male with symptoms of roseolo-petechiae rash, hyperemia, tachycardia, splenomegaly, and euphoria is Leptospirosis. Leptospirosis is a bacterial infection commonly associated with exposure to contaminated water or soil, which is prevalent in homeless populations. The initial diagnosis of "influenza" fits with the flu-like symptoms. The appearance of roseolo-petechiae rash and other symptoms like hyperemia, tachycardia, splenomegaly, and euphoria are consistent with leptospirosis. The other choices can be ruled out: A) Typhus typically presents with headache, fever, and rash, but not the specific symptoms described. B) Alcoholic delirium is more likely with a history of alcohol abuse and presents with confusion, disorientation, and hallucinations. D) Abdominal typhoid presents with prolonged fever, abdominal pain