Are there unusual epidemiologic clues?
To cite a few examples, in patients exposed to cats, cat-scratch disease or toxoplasmosis, which can also result from eating poorly cooked meat, may develop. Travel to the southwestern United States may suggest the possibility of plague. An appropriate travel history or exposure to bird droppings may suggest fungal infection, as may lacerations sustained during gardening in the case of sporotrichosis. Contact with wild rodents can result in tularemia, as can tick bites. A history of exposure to tuberculosis may be an important clue to scrofula. More commonly, community outbreaks can provide clues to the diagnosis of streptococcal pharyngitis or rubella, whereas a history of sexual exposure may raise the question of gonorrhea, syphilis, genital herpes, or lymphogranuloma. Laboratory Studies Laboratory studies need not be very elaborate. A complete blood cell count with differential often provides useful information and is almost always indicated. For example, atypical lymphocytosis sugg
