A 36 year old cattle farmer was admitted to hospital with a flu like illness. 3 days after admission he developed arthralgia and progressive shortness of breath. There was a soft systolic murmur over the precordium. Chest X-Ray showed bilateral infiltrates.
ECG showed non-specific ST-T changes. Troponin raised. Echo revealed decreased LV function.
Hb 90 G/L.
Reticulocytes 4% (0.5-2).
List 5 differential diagnoses for his presentation
a) Viral pneumonia
d) Q fever
f) Infective endocarditis
i) Vasculitis (unlikely)
This question closely resembles Question 25.4 from the second paper of 2009.