3rd August 2023

A 44 year old woman attends A&E with daily fevers for one week. She has recently returned from a month’s trip abroad

A 44 year old woman attends A&E with daily fevers for one week. She has recently returned from a month’s trip abroad as a freshwater conservationist in Mozambique, where she has often worked over decades. She also complains of an increasingly distended abdomen, cough, and diarrhoea but no urinary symptoms. She has urticaria, and, on auscultation, a diffuse wheeze across the chest is heard. Abdominal examination reveals hepatosplenomegaly.

Her blood tests are significant for eosinophilia and mild bilirubinaemia.

What is the most likely causative pathogen?

Select the SINGLE most appropriate option from the list below. Select ONE option only.