3rd August 2023

A 33-year-old Australian woman is visiting her family in the UK.

A 33-year-old Australian woman is visiting her family in the UK. Over the last week, she has had a fever, muscle aches, sweats, and a cough. On examination, she has an enlarged liver and spleen. Blood tests demonstrate a neutrophilia, raised CRP and deranged liver function tests showing a hepatitic picture. CXR shows multi-lobar consolidation. COVID-19 PCR is negative. She has been working in an Australian abattoir for the last 6 months.

What investigation will most likely establish a diagnosis?

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