CASE 5
A 32-year-old male presents to your clinic with complaints of a sore throat. He
reports numerous upper-respiratory infections over the last 3 months. Patient
states that he required antibiotics for some of the infections. The patient’s sore
throat has been present for 4 days and is progressively worsening. He is no
longer able to eat solid foods because of the pain. Nobody else in contact with
him has been ill. Patient gives a history of intravenous (IV) drug use in the
past, but no other significant medical history is given. On exam, patient is
found to have a temperature of 37.8°C (100.0°F) and is in minimal distress
from the sore throat. His pharynx is erythematous and has numerous white
plaques coating the throat. There is also prominent cervical lymph node
enlargement. His chest is clear to auscultation and heart is regular rate and
rhythm. A CD4 T lymphocyte cell count is performed and is less than
200 cells/mm3 (normal >500 cells/mm3). The responsible organism is composed
of ribonucleic acid (RNA) genome.
What is the most likely diagnosis?
What is the biochemical mechanism that the pathogen uses to affect
the patient’s cells?
What enzyme is required for this pathogen to affect the host
genome?
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