DDSEP® 8 Quick Quiz

August 2018 Question 1

A 44-year-old man with history of renal transplant, on immunosupression with prednisone and tacrolimus, presents to the emergency department with high-grade fever of 105 °C and confusion. He initially developed nausea, vomiting, and diarrhea for a few days after attending a dinner party. Later, he developed fever and headache. His symptoms progressed, with worsening neurological features, manifested as ataxia and tremors. Soon after admission to the emergency department, he developed seizures and lost consciousness, and was intubated to protect his airway. Routine labs were sent for investigation, and both CT head scan and lumbar puncture were performed. CBC revealed leukocytosis. CT scan was negative for any acute findings, and CSF fluid analysis revealed increased white blood cells, mainly lymphocytes, and low glucose.

Which of the following organisms is the most likely cause of this illness?

DDSEP® 8 Quick Quiz - August 2018 Question 1

A. Listeria monocytogenes

B. Mycobacterium tuberculosis

C. Neisseria meningitis

D. Enterovirus

E. West Nile virus

1. Garcia-Tsao G., Sanyal A.J., Grace N.D., et al. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46(3):922-38.
2. de Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV Consensus Workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 2005;43:167-76.

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