A 32-year-old male farmer presents during monsoon flooding with high fever, severe myalgia, marked tenderness of both calves, conjunctival suffusion and icterus. He had spent several days wading through floodwater mixed with surface runoff. The most likely source of his infection is:

• A Drinking water contaminated with sewage-borne Salmonella typhi
• B Inhalation of aerosols containing Legionella from stagnant tanks
• C Skin contact with water contaminated by urine of infected rodents ✓
• D Bite of Culex mosquitoes breeding in flood pools

Explanation

The triad of fever, calf muscle tenderness and conjunctival suffusion with jaundice after floodwater exposure points to Weil disease caused by Leptospira interrogans. Humans acquire infection through skin abrasions or mucosa in contact with water contaminated by urine of infected rats and other animals, making leptospirosis a classic water related zoonosis of floods. Typhoid lacks calf tenderness and suffusion, and neither Legionella nor Culex fits the exposure.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.