Review Question - QID 216575

A 45-year-old man presents with a 1-day history of vomiting, diarrhea, abdominal pain, and hand pain after eating oysters that he caught and shucked. His past medical history is significant for chronic fatigue, diabetes mellitus diagnosed 1 year ago, joint swelling, and decreased libido. His temperature is 101.4°F (38.5°C), blood pressure is 95/67 mmHg, pulse is 120/min, and respirations are 20/min. Physical exam is notable for increased skin pigmentation as well as a lesion on his hand that is warm, fluctuant, significantly painful, and erythematous with poorly defined margins. There is crepitus on palpation. Physical exam reveals the finding in Figure A as well as spider telangiectasias. Which of the following organisms is the most likely cause of this patient’s current presentation?