A 35-year-old captain in the army reserves has been plagued by a painful, erosive lesion near his ear lobe since his return from Operation Desert Storm several years ago. He denies exposure to the toxic by-products of burning oil fields. Punch biopsy of the leading edge of the erosion reveals macrophages distended with oval amastigotes. How was this infection acquired?

  •   Bite of reduviid bug
  •  Contact with contaminated drinking water
  •   Bite of Anopheles mosquito
  •   Bite of sandfly
  •  Fecal contamination of food
  •  Bite of tsetse fly