11th June 2024

A 44-year-old man is on holiday from Mexico in the UK. He presents with a 1-month history of progressive back pain

A 44-year-old man is on holiday from Mexico in the UK. He presents with a 1-month history of progressive back pain. In Mexico, he works in cattle farming. On examination, he has hepatomegaly and widespread lymphadenopathy. Bloods show raised inflammatory markers as well as deranged liver function. MRI of his spine has been arranged and shows L4-5 spondylodiscitis with a psoas collection on the left.

What is the most likely cause?

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