OK, guys. I've done the dip.
Clams don't look like this from nipping. My alk tests out to roughly 165 ppm KH (~9.5 dKH) so I've ruled that out, and at this point I had nothing to lose. Even the tank smells 'fishy' in that clammy sort of way.
As I'm dipping, I observed worms exiting. About three bristle worms, but there were two other smooth worms that I'll get a photo of when I'm done. Although I don't fault the bristle worms for this (they're just doing their jobs), I believe there are two other possible explanations.
1) I moved my tank about three weeks ago, due to a flood in my basement from the rainstorms here in the NE, and that likely stressed the clam to the point where a case of PM set in. Perhaps the suspected pathogen was already there, lying in wait until the clam was weakened just enough to attack.
2) The as yet unidentified worms are clam predators and were either introduced by the new clams in my system, or were there all along, and again, the stress of the move took its toll. Throw in a couple additional bristle worms, and voila! Clam crisis.
Stay tuned for more results. I don't expect the clam will survive, but there's nothing to lose by trying at this point.