Read the introduction below and proceed to complete each step of the activity that follows.
Charlie was a 26-year-old drummer from San Francisco. He was a high school music teacher who had just returned from participating in a teacher exchange program in Mali. A week after his return, he developed a reaction to what he thought was an insect bite on this left hand. After a few days, the site became swollen and blistered. Finally, the lesion turned into a dark black ulceration and it was at this point that Charlie sought out medical attention.
The following are the answers the patient provided to the patient history questionnaire:
Question: What have been the patient's symptoms?
Answer: I have been a little tired since returning from Mali, but other than this bug bite on my hand I've been feeling fine.
Question: When did the patient begin to exhibit symptoms?
Answer: The itching started about a week after I returned from my trip, and then it turned into this just a day or so ago.
Question: Has the patient traveled recently?