“ID” the Images
A 19-year-old man from India attempted to immigrate to the United States during a months-long journey. He initially traveled from India to Brazil by working on a ship. He then walked and hitchhiked through South and Central American countries through the Mexican/US border at Texas. He was arrested for crossing illegally and bused from Texas to the Chicago area. There, shelter volunteers noted that he had sores around both ankles and took him to the emergency department for evaluation. He provided a history of progressive, pruritic wounds on his feet that started a several weeks prior to his arrest but after arriving in Brazil. He denied fevers and chills. During his journey, he walked or swam over many streams and lakes and slept on the side of the road.
The Emergency Department had a differential diagnosis, which included the following. Which of these is most likely to be true?